Exploring Sensations in our body from a therapist in Madison

In 2021 I took a training called Sensorimotor Psychotherapy: Level 1 Trauma themes. It was a 6 month training. It changed a lot for me; my awareness of my own body, how I work with my clients, and how I approach therapy. I knew I needed another approach to work within the body. So often in my sessions I would hear from clients that they knew something logically but they just weren’t sure why they didn’t believe it. It dawned on me that believing it was connected to feeling it, embodying it and mind and body being in congruence around it. Sensorimotor Psychotherapy is a bottom up approach. While the resources used in sensorimotor psychotherapy- breathing, centering, grounding are similar to other approaches the way that I work with them is a little different. I also work with posture and movement.

One thing that really stood out for me was differentiating feelings from sensations. You might have been taught about feelings growing up, but most of you were probably not made aware of sensations. Because this is new to most of you, it was to me, I have included a list of common sensations that might help you bring some more awareness into our bodies.

Achy, airy, bloated, blocked, breathless, bubbly, burning, buzzy, chills, churning, clammy, clenched, congested, constricted, cool, cold, damp, dense, dizzy, dull, electric, empty, energized, faint, flaccid, flushed, fluid, fluttery, floaty, fuzzy, goosebumps, heavy, hot, itchy, jerky, jumbly, knotted, light, moist, nauseaous, numb, paralyzed, pins and needles, prickly, puffy, quaking, quivery, radiating, sharp, shivery, shuddering, sore, stiff, suffocating, sweaty, tense, think, tight, tickley, tingly, trembling, twitchy, vibrating, warm, week and wobbly. (Ogden, P. & Fisher, J.,Sensorimotor Psychotherapy, Interventions for Trauma and Attachment)

I work a lot with anxiety. So an example of what someone may be experiencing with anxiety could look like the following. If a client comes in with anxiety they may describe feeling anxious, or nervous. Those are feelings and that is really good awareness. I might ask what sensations go with that anxiety. In general many people do not know or haven’t thought about it. So we take it a step further and I would note that sometimes when I feel anxious my heart starts racing, I may notice a warmth or sweatiness, my stomach might feel like butterflies, fluttering or a knot, sometimes my shoulders feel tight or tense. Once we notice these sensations we can work with them.

What sensations do you notice in your body?

To learn more about working with sensations in the body, contact me (therapist Madison) julie@kullcounselingmadison.com.

Postpartum PT Care, Interview with a therapist in Madison

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

Julie: Hello Jessica,

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

Jessica: Hello,

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

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

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

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

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

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

Peeing when you don't want to

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

Difficulty with internal menstrual product use

Pain with penetration, including sex, exams, menstrual products

Scar tissue restrictions or pain (perineal or cesarean)

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

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

You may also be looking for guidance on exercise or fitness

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

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

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

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

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

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

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

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

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

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

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

Julie: What are the benefits that PT can offer?

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

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

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

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

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

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

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

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

that_ pelvic _lady.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The emotional toll of a Missed Miscarriage

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

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

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

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

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

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

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

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

October is pregnancy and infant loss awareness month 2020

October is pregnancy and infant loss awareness month. For me it is the time of year that I think about the baby that I lost through miscarriage. October is the month that I found out I was pregnant. I told my husband by buying pumpkins. One for him, one for our daughter, one for me and a tiny pumpkin to let him know we had a new pumpkin on the way. It was such a happy moment and I remember it so vividly even though it was 6 years ago now. Even though I know it is coming every year I am still surprised by it every year. This year it came early. My rainbow baby pointed to a small pumpkin the other day on our walk and said, “oh mom, look how cute this baby pumpkin” is.

Do you have moments like this? A memory or object that bring up thoughts of your baby?

This month is pregnancy and infant loss awareness month. This year is Covid-19. Usually it is a month filled of events that help you by bringing together a community of families that hold their babies in their hearts instead of their hands. This year that will look different. I have included a list of some virtual events in the Madison area. I know this year may be difficult for you because community can be such an important part of your healing journey. Please know that even though we are not able to gather in person, there is still a community here to support you.

OCTOBER:

1st: Miscarriage support group - The free monthly miscarriage support group will meeting virtually on October 1st from 5 - 6:15 p.m. Please email julie@kullcounselingmadison.com to register.

3rd: 10 a.m. CST: Now I Lay Me Down to Sleep virtual walk

The Virtual Walk includes an online presentation with readings, music, and speakers to honor your baby. During the presentation, each baby is honored by having his or her name read aloud.

Also the 3rd: Harley’s Hustle virtual 5k Set your course, set your pace, and just run. Share your pictures by tagging @HarleysHustle on social media.

8th: 6:30 p.m. GPS Hope Janesville (2nd Thursday)

12th: 5:30 - 7 p.m. Bo's Heavenly Clubhouse Support Meetings at Higher Grounds Coffee Shop in Beaver Dam (2nd Monday)

15th - 18th: Forever In Our Hearts Remembrance Day: Join by creating a sense of community and support found at in-person walks. There are many ways to join this event - purchase a yard sign, walk in your community, watch a video of the names of babies being remembered this year, and so on.

26th: 5:30 - 7 p.m. Bo's Heavenly Clubhouse Support Meetings at Higher Grounds Coffee Shop in Beaver Dam (4th Monday)

For more information on miscarriage or the above events email julie@kullcounselingmadison.com or 608.239.4807.

Pregnancy after a loss meditation script

Being pregnant after a loss can come with an increase of anxiety. Meditation can be a great way to get in your body, become aware of how you feel, and to stay present. Recently I recorded a meditation which can be found on the pregnancy after loss page on my website.

Here is the script:

Pregnancy after loss meditation-

I invite you to get into a comfortable position either with your feet on the floor or lying down. Rest your hands by your side or in your lap and begin to close your eyes.

Today we are going to be talking about pregnancy after a loss. There are many thoughts that can come up for those pregnant after a loss.

I invite you today to acknowledge your thoughts and just notice them, without judgment.  Our thoughts are not facts.

There is no wrong way to meditate. Meditation takes practice and it is okay if your mind wanders, if you notice your thoughts wandering simply let them go and bring your awareness back to your breath.

We will begin by bringing awareness into the breath. Inhale to the count of 3 and exhale to the count of 4. If at any moment today something feels uncomfortable in your body please skip it. We will continue to breath in to the count of 3 and out to the count of 4 bringing attention to our breath.

Breath in and out

In and out

We will begin by bringing awareness into our body. Starting by bringing awareness into our head, notice how your forehead, your eyes, your mouth, your cheeks your ears are feeling, notice any sensations without judgment.

Now bring your awareness down your head to your neck and shoulders, simply noticing how you are feeling.

Now draw your attention to your chest and back and simply notice. Continue to breath into the count of 3 out to the count of 4.

Bring your awareness into your arms and then your hands. Notice if they feel heavy, light, warm or cold. Simply notice how they are feeling at this very moment.

Continue down your body now into your lower back, stomach and hips noticing any sensations. Continue traveling down into your legs and toes continuing to breath and notice any sensations.

Take a deep breath in through you head and breath out through your toes.

We will now return to our heart and our stomach. If it feels okay to you bring one hand to your heart and another to your belly.

Continue to breath in to the count of 3 and out to the count of 4.

Bring breath and awareness to your heart and your belly. Your body is strong. Your body can grow a healthy baby. You can hold love in your heart for both your loss and for the new baby growing inside of you.

Whatever emotions you are feeling inside or okay. Emotions are not good or bad, they just simply are. Notice your emotions without judgment and bring your awareness back to your breath.

Continue to breath. If you have an intention for your pregnancy you can say it silently now.

As we start to return now to the room know that your baby is loved, that your body is strong and capable of caring for this baby.

Know that meditation is available whenever you need it. You can return to these feelings of calm whenever you need to.

I will count back from 5 and then we will return to the room.

5, 4, 3 begin to bring movement back to your body, 2 bring awareness back to the room 1 open your eyes.

For more information about pregnancy after a loss please contact Kull Counseling, LLC at 608.239.4807 or julie@kullcounselingmadison.com

October is pregnancy and infant loss awareness month

In 1988 Ronald Reagan declared October as Pregnancy and Infant loss awareness month http://nationalshare.org/october-awareness/

“When a child loses a parent, they are called orphans.

When a spouse loses a partner, they are called a widow or widower.

When a parent loses a child, their is not a word to describe them.” -Ronald Reagan

Every October we take a moment to honor babies gone too soon. For many this may be a very difficult time of year, but can also be a time of year for healing.

Here in Madison we are fortunate to have some great resources for those who have suffered pregnancy or infant loss.

October 2- Lunch and Learn about Pregnancy after a loss at Madison Area Parents Support

11:30-12:30 p.m.

Psychotherapist Julie C Kull, LCSW will lead a lunch and learn discussing education and coping skills for pregnancy after loss.

https://www.madisonareaparentsupport.org/calendar

402 E Washington Avenue at MAPS Base Camp

October 3- Kull Counseling Miscarriage Support Group

5:30-6:45 p.m.

This support group is run by psychotherapist Julie C Kull, LCSW. The purpose of this group is to provide a safe place to share your loss and connect with others in the early loss community. We will be painting rocks to honor your babies in October.

720 Hill Street, Madison, WI

To register contact Julie at 608.239.4807 or julie@kullcounselingmadison.com

October 17- Bereaved Parents of Madison Support Group

7:30pm (Doors open at 7:20pm)
St Mary's Hospital in Conference Bay 4
700 South Park Street 
Madison, WI

October 19- Remembrance Day hosted by Mikayla’s Grace

“This Remembrance Day is to honor families who have lost babies through pregnancy, stillbirth, or in early infancy. This 9th Annual Forever in Our Hearts Remembrance Day is being planned by local bereaved parents and Madison area non-profit Mikayla's Grace.”

BTC Events in Fitchburg, WI

What to expect at the miscarriage support group

I often get asked about the free monthly miscarriage support group so I thought I would take the opportunity to share a little Q & A about what you can expect if you are thinking about attending.

When and where does the group meet?

The group meets the first Thursday of every month from 5:30 p.m. to 6:45 p.m. at 720 Hill Street.

Why do I need to register and how do I register?

I do ask that everyone registers in advance. This lets me know how many I can expect so that we will have enough people to make a group. I know how hard it can be to get the courage to come in for a group and if we do not have more than one participant than we cannot hold a group that month. I also ask that you register so that I can send you a few questions to make sure that the group would be a good fit for you. You can register by emailing julie@kullcounselingmadison.com or calling 608.239.4807.

What is the purpose of the group?

The purpose of the group is to find support and connect with others that have been through a miscarriage.

What can I expect at the group?

You can expect a relaxed atmosphere and an inviting space. I usually start the discussion with a few reminders, an introduction and sometimes a quote or intention. I invite everyone to talk when they are ready to. It is not a requirement that you participate but I find that most people are ready to share when they come. I keep the group small so that is not overwhelming. You may not be in the exact same place as others but more than likely you will find that you have some things in common with the other participants. If the group happens to fall near a holiday or a due date we often discuss these and ideas on how to cope.

Is the group religion based?

No. Everyone is welcome. Everyone is also welcome to share their beliefs as it pertains to their loss. We respect that people have different beliefs.

How much does the group cost?

Nothing! This group is free of charge. I want everyone to be able to access it.

Who is appropriate for this group?

Anyone who has had a loss before the 20th week of pregnancy.

Can my partner come?

Yes partners are welcome.

What can I do if I have more questions?

If you have questions or would like to register please contact Julie at julie@kullcounselingmadison.com or 608-239-4807.

Anxiety and Infertility

1 in 8 couples struggle with infertility. Infertility is a disease that carries a lot of stigma. If you are going through infertility, it is common that you may be feeling: shame, loss of control, detached from your body, sad, angry, emotional, depressed, and even anxious.

Anxiety is common when going through infertility.

In Rewiring your Anxious Brain, by Catherine M. Pittman, PHD and Elizabeth M. Karle, MILS, you learn that anxiety can come from the cortex or the amygdala. The anxiety that develops in the cortex, is the anxiety that you interpret; the “what ifs”. What if you never get pregnant? What if you never become a parent? What if you do get pregnant and lose the baby? What if infertility ruins your relationship?

In addition, these thoughts are usually accompanied by physiological symptoms. This is anxiety that comes from the amygdala. Anxiety that comes from the amygdala is the physical sensations and anxiety of past experiences. This type of anxiety contains the triggers and associations. Examples include feeling anxious every time you see a pregnancy test because it was negative before and that caused anxiety. Also, anxiety about going to the doctors office because the last time you were there you got bad news.

Anxiety symptoms can include, but are not limited to, racing thoughts, rapid heartbeat, sweaty or clammy hands, upset stomach or butterflies, tight muscles, inability to focus, feeling lightheaded, and dizziness. Everyone experiences anxiety, as it is our body’s coping mechanism for danger. It is when there is no danger and our body still goes into the fight/flight/freeze mode that it starts impacting our functioning in life and becomes an anxiety disorder.

Stress is a common trigger for anxiety. If you are going through infertility this can be a stressful time in your life. Infertility treatments can also be emotionally and physically stressful. If you are feeling anxious you do not have to let it control you.

Here are some ways to deal with your anxiety:

1. Exercise - When you exercise you can lower the baseline for your anxiety so that it doesn’t peak every time you start to notice your symptoms of anxiety. Exercise is also great when you are feeling anxious. When your body goes into fight, flight or freeze mode your body sends energy to the parts of the body that you need to either fight or flee, when you exercise you can use up that excess energy allowing your body to get the message that you are no longer in danger.

2. Breath - If you are feeling anxious one of the best things that you can do is start to take some deep breaths and start to notice your breath. When your body is in the fight or flight mode our breathing becomes quicker to get more oxygen into the parts of our body preparing to fight or flee. When you start to slow down your breath your body gets the message that you are no longer in danger.

3. Take charge of what you are in control of - If you are going through infertility, it can be easy to feel out of control. Write down your anxious thoughts. In one column, put those thoughts that you have control over. In the other column, put those thoughts that you do not have control over. Take the list that you have control over and work on those things. Rip up the other list.

4. Say no - It can be very difficult some days to be facing infertility. You do not have to go to every baby shower or every kid’s birthday party. You do not have to join in on every holiday. You get to decide what you can handle that day. You do not have to listen to people’s advice or tips on how they got pregnant. It is okay to say no and to set boundaries.

5. Be kind to yourself - Going through infertility is not easy. It is very important that you treat yourself kindly through the process-self affirmations, self care, mediation, support groups, counseling. These are all great ways to show yourself kindness through this difficult journey.

   If you are struggling with infertility and anxiety you are not alone. Please contact Kull Counseling, LLC to learn more about coping with anxiety during infertility. 608.239.4807 or julie@kullcounselingmadison.com