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5 Reasons you might need to see a Perinatal Mental Health Therapist |Birth Photographer Salisbury MD

Mental health can be such a tricky subject when hormones and life changes are happening, both of which are a huge part of the whole becoming a parent thing!

Emily Souder, LCSW Baltimore MD

Emily joined me live on Instagram for this interview, if you'd prefer to watch click HERE (skip to about the 3-minute mark for the goods to start!) It was nice meeting Emily (and her two kids) through this platform! Having kids interrupting is such a familiar thing, #amiright?

After we said our hellos and talked a little bit about our kids and their ages we jumped right into the interview!

Me: Would you mind introducing yourself and telling us a little bit about what you do?

Emily: Yes! I'm Emily Souder, I am a therapist, a licensed clinical social worker. I live right outside Baltimore. I'm certified in Perinatal Mental Health. I work almost exclusively with parents in the perinatal period. I have a couple of clients with kids who are young, it's a little bit of a spectrum but mostly I work with people during pregnancy, postpartum and some in the trying to conceive period. I also have a separate business as an intuitive guide and reiki practitioner. I have two kids, we are a homeschooling family. I love reading and tea and being outside as much as possible!

Me: Awesome, thank you! So what was it that brought you to working in mental health and then how'd that carry into perinatal mental health? Did you always know you were going to specialize in that?

Emily: So I didn't know. When I was in social work school I had dual interests in both mental health and health. I ended up working in a hospital setting and I figured out that wasn't for me. Then I worked more generally in anxiety and depression. But I quickly realized that after what I went through during my pregnancy and postpartum like Goodness Gracious! People need way more support in this area. There wasn't enough awareness, particularly in anxiety is what I experienced, there wasn't enough awareness and support. So I really wanted to be a part of that and connect to parents in that way. That's when I started my practice. It was slow to grow, it's a really interesting time to start a business when my kids were so young. It was a really busy sort of time! So I didn't always know, but it became clear pretty quickly.

Me: Why is mental health during the perinatal and postpartum time so important?

Emily: Mental health is important throughout the whole course of our lives. But when it comes to those really tender and we are developing this parenting identity and journey and we are figuring out who we are as parents. It's the foundation of how we are connecting with these kids that we are bringing into our lives. It really affects our ability to show up for that connection and develop that relationship. And also, just the quality of our lives! To be able to enjoy it as much as we can. If we are able to identify it then and get the support it can save us a lot of challenges later.

A lot of people are able to sort of white-knuckle it through but they didn't learn the skills and the support to help them heal. True deep healing and figuring out the best ways to do that.

Me: Yes! I love that, it's so important. So what are some things that a parent may be experiencing that means they should be looking for help? Going along with what you were just saying, so many people are just like this is what it's like to be a mom or pregnant or a parent. So what kinds of things can we look for that means we do need to heal?

Emily: Anything that is taking you away from your ability to be present from day to day. Anything like that that is pervasive and getting in the way of your ability to do that. Whether it's anxiety and depression. Feelings like you're not connected to your baby after birth. Now, I will put a caveat- there is a whole range. Some of us feel immediately connected to our baby when we get pregnant but some of us don't. And that's ok. But if that persists and there's not that connection after baby is born then that can be a clue. Feelings of hopelessness, self-harm, something that birthing people are really bothered by but are more common than you'd think are intrusive or scary thoughts. Visions of something happening or us doing something to baby or ourselves. That can be really scary and unsettling, particularly if a person has never had intrusive thoughts. Things like that can be a sign to connect with somebody to learn about maybe normalize, you're not the only person. Thoughts that your family may be better off without you.

The thoughts that we have that are intrusive, visions of something happening, those are so uncomfortable to us because they aren't aligned with our beliefs and values and things we would actually do. When to be concerned is when we have those thoughts come in and they seem like a viable option or thought. Another thing to be aware of is if things are persisting 4, 6 weeks postpartum, that's when they aren't really the baby blues anymore. After two weeks you want to say maybe it's time to reach out for additional support.

Me: I didn't give you this question in advance but I had a question- people are becoming more aware of postpartum depression and anxiety but I think people don't understand antenatal or perinatal depression and anxiety, that happens when you're pregnant. Is there anything you speak on with that subject?

Emily: Yes, some of us experience anxiety and depression feelings, questioning if this was a mistake. But that might be a good thing to explore. What's under that? Maybe, for example, our experience with our own parents and that wasn't ideal and we didn't have good role models. So kind of lifting those feelings up and exploring is great and having guidance to do that is really helpful. Knowing you are 100% not alone. We do hear more about postpartum but it can happen during the whole pregnancy period and even the trying to conceive period, particularly for those having fertility challenges. The good thing is that more awareness is coming to that, but we have a long way to go still.

Me: yes, for sure. What do you think the benefit of writing out our birth story is?

Emily: Yeah, yeah! That's something I'm really passionate about. It gives us the possibility to explore and be curious. We can invite that curiosity in and not just look at the facts but look into the feelings within us and fill in a more complete story and we can get a better understanding of how we are entering into that parenting role. So many details or feelings get lost and we move on because we have to, life with a newborn can be crazy! but also because we don't want to explore that. But there is some definite value in doing that and sitting with it and being able to see "oh yeah there was this upsetting thing" and there was another theme of support and love, and gratitude and those things can exist together. Writing out your story but asking yourself to reflect more deeply can bring out those themes! And really to see if there's a part of this really upsetting thing that happened that's ready to be released. Sometimes it is and sometimes it isn't ready. But at least being able to be fully aware of all of that.

Me: I'm going to give you a little plug because if you need help with this Emily has written a guide, "Birth Story Brave, Reimagined" it's a guide for reflecting on your childbirth experience! I just got a copy, I haven't had time yet but I can't wait to dig into that. Just like you said, you can look back and see some of these parts are really bothering me but some of them were really beautiful. Just to be able to get it all out and heal from it!

Emily: Oh I can't wait to hear what you think about it and I hope it serves you well! I found some things, that were totally surprising, that I wasn't expecting when I did my own, and I really needed that.

Me: What is one thing you would like every woman to know?

Emily: I think the biggest thing, and it's something we say a lot but you're not alone. There is support out there for you. And even bigger than that, life will not feel this way forever, particularly if you find support in one way or the other. Life will not always feel this way if it's feeling challenging or difficult. I remind myself of that on a regular basis.

Me: Yeah, I love that. That's something I really appreciate, finding community with people who have gone through or are going through the same things I am is helpful to get through it. It's important.

Emily: Absolutely.

Me: So in your opinion, what is something that we could do better to support people better in their pregnancy or even in their trying to conceive period to early parenthood?

Emily: Honestly, just giving them space to authentically express themselves. Even if it's not necessarily positive emotions that they are experiencing. It's so valuable to be the safe place that someone could say "ugh this sucks" or "I'm not enjoying this pregnancy" or "I'm thankful I'm pregnant and my body hurts". To be that safe place that you can authentically express, whether, in a friend relationship, or a working relationship, it's such a place where people can just exhale and be themselves fully. There's not much permission for that in pregnancy and postpartum. It's getting better there is still that "it doesn't matter because you have a healthy baby" or "it doesn't matter because of this" and the shoulds are just not helpful. You should be able to be both. We can be thankful that we have a healthy baby AND still need healing from a certain thing. It can be both and I think to be that place for a person just to listen and say "I hear you and that sounds really hard."

Me: yes! So important! This is my fun question- If you were stranded on a deserted island, what 5 things would you have to have with you?

Emily: Oh I meant to think about this question- I love this question! Ok, I guess my first thing is oh I need sunscreen but I want to be the logistic things aside. I would need some good reading. Can I bring a person? I don't know who it would be but someone who is a great partner for solving problems and being creative, it could be my husband I don't know. I'm a tea person so I would need some tea options for hydration and enjoyment! I just picked up some amazing nectarines from the farmer's market so I'm going to go with those and music, something to play music on!

Me: yes! I love hearing it- some people go real logistical, some people go for fun!

Emily: Yeah my brain went straight to logistical things but I wanted to be fun.

Me: It turns out we need a lot of things!

Emily: Yeah I need bug spray!

Me: Ok so what does working with you look like?

Emily: In the therapy role, I tend to see my clients weekly, sometimes every other week. It really depends on how severe my client's situation and symptoms are. If their symptoms are getting in the way of life, absolutely that will be weekly. We always have an intake, that's where I ask a lot of questions. It lasts longer than normal. I ask a lot of questions to get the background, the landscape of that person's life as best we can. Trying to get the lay of the land and share some information with them. I really like my clients to feel that we are in partnership. Yes, there is some educating and I'm guiding through techniques. But as far as if something is working or not working I really like it to be collaborative. When we meet every week there's a short how's it going and then I ask what they want to focus on today. Keeping in mind their original goals I'll use techniques from acceptance and commitment therapy, some from cognitive behavioral therapy, mindfulness, and distance reiki for those who are open to it. Like if we are doing visualization and we are doing something about going into their bodies I found that distance reiki can support that really well.

Me: I know I've heard that for people that have experienced birth trauma, EMDR can help with that, is that something you have experience with?

Emily: EMDR can absolutely help but it's not something that I am trained in. EMDR and brain spotting are things that I typically refer out for. I always think of healing as coming in layers. So maybe we do one layer or we start with that layer. It's not surprising that if you go through birth story brave that other things come up. That's normal and expected but I usually refer out for those two things. They are similar but different. There's a particular therapist I refer out to because I know she has familiarity working with the perinatal population.

Me: Awesome. So is there anything else you want to add?

Emily: I don't think so! I'm so glad we got to chat and connect. Your work is beautiful and what you bring to the table is so beautiful. It's another way to look back and heal. I think that also helps to create a whole picture and your work is just beautiful.

Me: Aw, thank you! Yeah, I'm a little passionate about that and birth stories, and just like you were saying having an experience that was not what you wanted or was painful, or you felt unsupported. On the flip side, having these pictures helps you to see things that happened that your brain may not be focused on and it can be so helpful to remember all those other things.

Emily: Yeah, it's another side of storytelling. I love it.

Me: Thank you. So this is a bonus question that I did not give you earlier. But if you had to describe yourself in 3 words what would they be?

Emily: oohh... I think passionate. I tend to have super strong ideas about things. Open and compassionate. Compassion comes easy to me. I'm also pretty silly. Seeing life through a lens of amusement is me. It allows me to see life from a view of humor and curiosity.

Me: That's awesome. If anyone wants to connect with you, what's the best way to do that?

Emily: On Instagram and my Website are the best ways!

Me: I think it's so helpful to know that you're coming from such a similar place as so many that might be looking for help. It's part of the reason I'm doing this project- when you're doing something that is so intimate and personal- getting to know the person that you might be inviting to help you and support or is so important. It could be the difference between committing to getting help or continuing suffering.

Emily: Absolutely, and the hardest start can be that first email!

Me: Yes, Thank you so much for joining us and to your children for sharing you with us!

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