Pregnancy and Infant Loss Awareness Month: Your guide to resources from a therapist in Madison

“A wife who loses a husband is called a widow. A husband who loses a wife is called a widower. A child who loses his parents is called an orphan. There is no word for a parent who loses a child. That’s how awful the loss is.”

— Ronald Reagan

October is Pregnancy and Infant Loss Awareness Month. Here are some local events around Madison, WI to honor the babies gone too soon. At the end of the list are some options for ongoing virtual support on a national level.

October 6th- Fundraiser at Octopi Brewing Company for the Hope and Loss Clinic

October 7th- Forever in our Hearts Remembrance Day Walk and Ceremony

October 8th- Morning Coffee with the Alana Rose Foundation

October 11th 12-1 p.m. Free Miscarriage virtual Support group hosted by Julie from Kull Counseling (therapist Madison)

October 12th Pregnancy and Infant Loss Remembrance Day - Advocate Aurora Oshkosh 2023 5-7 p.m.

October 15th Wave of Light at 7 p.m.

October 19th 6:30-8:30 p.m. The Bereaved Parents of Madison Hosts and in person support group

Other virtual options for support include Postpartum International and Return to Zero.

For more information about local support for Pregnancy or Infant Loss in Wisconsin. Email Julie C Kull, LCSW.

How therapy can help after a miscarriage

It is estimated that 1 in 4 women will have a miscarriage. You may be feeling like if it is so common that you “should” be able to deal with it on your own or that it will not impact you or maybe even that it isn’t a big deal. For most people it is a big deal and it can be pretty hard to cope with.

Statistics suggest that 30-50% of women experience anxiety and 10-15 percent experience depression up to 4 months following a loss according to FIGO.

NIHR discusses a study that found 1 in 3 women show signs of PTSD after a miscarriage.

So why is this important? We know that the mental health of the mother can greatly impact the child even in pregnancy. Their are many studies that discuss the impact of the mental well being of the mom in pregnancy and the long term impact it may have on the child’s physical, emotional and cognitive development. Many women will become pregnant again soon after a miscarriage but long before anxiety and/or depression symptoms have subsided. While it is common to think getting pregnant again after a loss will decrease anxiety it often does not. Seeking therapy after a miscarriage can impact your ability to cope and decrease anxiety/depression in subsequent pregnancy.

How can therapy help?

Normalize- Many of the feelings you may be feeling are common for those that have had a miscarriage. Knowing that your feelings are okay and that there are ways to cope. Knowing that it is hard to have a miscarriage, that women do seek therapy and sometimes medication after a loss and that most people do not just “get over it”, even if it is common.

Validate- I am just going to say it- people are sooo uncomfortable with grief. You may be finding it really hard to express your feelings with family and friends. This can be even harder with a pregnancy loss that it can be when losing a friend or a grandparent. Often the people in your life may have not had an attachment or even known about the pregnancy before. It can be hard for people to relate to what we call an ambiguous loss. It can be really healing to have your feelings acknowledged and validated.

Help you to identify healthy ways to cope with grief- Unfortunately trying again or gods willing it or at least you know you can get pregnant are not the kind of healthy ways you need to deal with grief. But, acknowledging your feelings, finding support, creating a container for your grief, nurturing yourself, honoring your loss, making meaning and acceptance can be.

Set boundaries and ask for what you need in relationship- If you are in a relationship you probably are already starting to realize that you are your partner are grieving this differently. This also applies to family members that may need a gentle reminder on what you need to feel supported or the acknowledgement that this person in your life might not have the ability to support you through this for whatever reason and ouch can that really hurt.

Understand the grief and trauma around pregnancy loss- Understanding a framework for grief and what you have or might experience can help. Looking at your loss and understanding the trauma that can be experienced can also be really helpful in understanding how it has impacted you and what makes it difficult to process. Working with those triggers, increasing your window of tolerance and helping you to feel more regulated can make a difference.

If you still aren’t sure..find out more or schedule a free 15 minute consult here with a therapist Madison.

Pregnancy after infertility

You have been trying for days, months, maybe even years. Part of you felt that it was never going to happen, maybe you even started to prepare yourself for that and then it does. And maybe you feel some joy, but you might also feel shock, denial or numb. It might not feel real even after you take pregnancy test after pregnancy test. Everyone has advice to give when it comes to getting pregnant when diagnosed with infertility but what happens when you get pregnant after infertility?

Does the infertility diagnosis go away?

No! You are not suddenly cured because you now are pregnant. It doesn’t take away the stress, the longing, the anger, the resentment, how its impacted your mental health or your finances or the impact it had on relationships.

Why do I feel like an imposter?

You may feel like an imposter after getting pregnant. You have wanted to be in this group of pregnant people for so long and now that you are here it doesn’t feel right. You feel like you don’t fit in. Infertility has changed you and changed this narrative you have had about becoming a parent.

Why do I fell guilty?

You may even feel guilty after becoming pregnant. It is common to feel guilty about leaving behind those that are still struggling with infertility. This can be isolating and feel very lonely. If you are feeling like an imposter in the pregnancy group, but also no longer feel like you fit in the infertility groups it can be hard to feel supported.

I am pregnant so I can’t complain.

It is so common for women to feel like if pregnancy is hard or not what they expected that they are allowed to feel this way. You may be telling yourself well this is what I wanted so I can’t complain or you may also be hearing this from others or well you got pregnant what did you expect. Even if you have a very wanted pregnancy that you tried very hard to get, pregnancy is still hard, uncomfortable at times, and not what you expected. Your feelings are VALID!

I don’t feel attached to my pregnancy.

It is common after infertility or a loss to not feel attached right away. This is your protective part telling you this isn’t safe, we need to protect you. For most of you this will grow and develop naturally. If it doesn’t feel like you are slowly starting to develop or that it is feeling more and more real- therapy can help.

I am feeling anxious.

It is common to notice some anxiety or sadness about being pregnant. If you are noticing these frequently or noticing that they are increasing it is important to get help. If you are noticing intrusive thoughts, nightmares or flashbacks there is help.

To learn more about infertility counseling in Madison or anywhere in Wisconsin or to set up your free 15 minute consultation you can reach me here for a therapist Madison.

Meditation for miscarriage, pregnancy after loss and new moms

I remember trying to meditate for the first time. I made every excuse in the book to avoid it. I convinced myself that I did not have time, convinced myself that it wasn’t a good use of my time, that I wasn’t doing it right so what was the point. It took YEARS until I developed a regular practice and it is still a work in progress.

Meditation has so many unbelievable benefits. According to Positive Psychology.com , meditation can reduce physical, mental and emotional disturbances. This can include anxiety, depression, pain, blood pressure, stress, migraines, IBS, ect. Meditation can be so effective.

So if it is so great, why isn’t everyone doing it? What I hear often is that it is hard, you may think you are doing it wrong and if you are doing it wrong what is the point? Other reasons can include you may feel uncomfortable, overwhelmed or don’t want to feel anything.

All of the reasons are valid. I like to invite my clients to start small. Try to take one minute everyday where you just try to tune into your body and breath and go from there. Many of you may find it is easier to do when you have someone guiding you. I certainly do! There are meditations everywhere it seems but finding one that resonates with you is important.

Recently I have created some meditations with you in mind. My library is building slowly but I currently have meditations for miscarriage, pregnancy after loss and motherhood. I will be adding more soon. If you are looking for a specific meditation that is a fit for you please- DM me, reply to this newsletter and let me know what you are looking for and I will do my best to make that available to you.

Interested in learning more about the meditations from a therapist Madison? Click here.

Happy Meditating!

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/

Coping with Anxiety and Covid-19

In the last few weeks it may feel that your world has been turned upside down. Many of you may be quarantined, social distancing, staying at home or safer at home. In this time of uncertainty, Covid-19, many of you may be feeling an increase of anxiety. Here are some tips for managing anxiety during the pandemic.

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.

    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.

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

How to love your body through infertility

Infertility is the inability to conceive or sustain a pregnancy after 1 year (for women less than 35 years of age) or after 6 months (for women over 35 years old).

If you are struggling with infertility you may feel anger, guilt, shame, depressed, or broken. It is common for women going through infertility to struggle with anxiety or depression. But one of the things that I rarely see addressed is how women feel about their body while going through infertility. You may be feeling like your body is broken, like it let you down and is not doing its job to reproduce. If you are a woman, odds are you may have a history of a body dissatisfaction. Infertility may be bringing up some new feelings about your body or triggering ones from your past.

You may hate your body.

You may want to punish your body by saying mean things to/about it. You may want to punish your body by dieting, restricting or bingeing food. You might even want to hurt your body. You may have a hard time connecting with your body, struggling to remain intimate with your partner, or even feeling numb in certain areas.

If you are going through infertility, you are not broken.

Here are some ways to love your body through infertility;

1. Challenge your negative thoughts about your body - When you are having negative thoughts about your body it is easy to see your body as broken or bad. It is easy to want to punish your body or even to hate your body. By challenging these negative thoughts we can examine where they have come from, what proof we have to support them, and how to reframe them.

2. Praise your body - Even if you do not believe what you are saying, even if you cringe while you are saying it, say it. Start by focusing on the part of your body that you do love or that you feel is strong. Focus on the functions of your body and what it truly does for you. If you have other children this is a great activity to do together. This is also something you can do while doing a physical activity. Examples of this are, “I love my feet because they allow me to run many miles” and “I love my hands because they are steady and stable allowing me to create a painting or piece of pottery.”

3. Positive affirmations - When thinking of negative statements (i.e. “my body is broken”) try to mentally or verbally replace that statement with a positive statement about your body. For example, “I love my body” or “My body is strong” or “My body is amazing” or “My body can do so many things.” Start each day by looking in the mirror and saying one positive thing about your body.

4. Give your body the proper nourishment - Fill your body with foods that give you energy and make you feel good. Feed it until it is full. Nourish it when it shows signs of hunger.

5. Let your body rest - Trying to get pregnant is tough work. You are challenging your body physically, mentally, and emotionally everyday while trying to get pregnant. Being aware of when your body needs to rest; self-care is necessary. For most people, that is 7-9 hours of sleep and may be even more when undergoing procedures or fertility interventions.

6. Move your body - Physical and mental exercise is helpful.

7. Practice mind/body exercises - Mind/body exercises are those that combine breathe work with mental focus and body movement. This could be yoga or tai chi, as well as grounding exercises or progressive relaxation.

8. Know when to get help - Many women suffer from an eating disorder, disordered eating, and/or body image concerns in their lifetime. If going through infertility is triggering any disordered eating behaviors such as restricting, bingeing, purging, only eating certain foods, feeling detached from your body, or punishing your body in any other way it is time to seek professional help.

For more information on loving your body through infertility contact Julie at julie@kullcounselingmadison.com or 608-239-4807.

The importance of self care

Self care. Do you feel like you are hearing those two words everywhere? Have you ever wondered what self care is and how to do it? Self care is defined as any activity that we do deliberately in order to take care of our mental, emotional, and physical health according to  Psychology Today.

Self care is not just exercise or meditation but it certainly does include these things. Self care includes all the different areas in your life: Physical, Spiritual, Social, Cognitive/Mental. 

Physical- How can we physically take care of our bodies? One way is through movement. Exercise is a great form of self care. Examples include: Running, Walking, yoga, pilates, tai chi, stretching, dance, cleaning, hiking, kayaking, swimming, bicycling, getting a massage, and gardening are a few examples. The second physical way that we take care of our body is how we nourish it. What food are you putting into your body? Are you eating a balanced diet? How are you eating? Do you rush through your meals? Do you rely heavily on meal replacements? Are you cooking your meals? Or if you cook often can you take a break to eat at a restaurant? Self care and nutrition can look different depending on your dietary needs.

Spiritual- Are you nourishing your spiritual side? For some that may mean organized religion, for others that may be more spiritual or even philosophical. Examples include: going to church, volunteering within your religious community, taking time to be in nature, connecting to your spiritual side, taking a day of rest, prayer, meditation, or devotions.

Social- Self care for our social side can include social activities and social support. Social activities can include taking a class with others, going to a movie, going out to dinner, playing a sport together, going for a walk or joining a club, volunteering, joining a board, and hanging out with friends to name a few. Social support can include: friends, family, neighbors, religious community, colleagues, 

Cognitive/Mental- Cognitive self care involves stimulating your mind. This can include: reading, learning a new skill, taking a class, learning about something new. This also includes getting enough sleep. Mental self care is nourishing our emotional health. Examples of this include: mindfulness, meditation, journaling, painting, drawing, listening to music, playing an instrument, seeing a psychotherapist, and practicing relaxation exercises.

There are many ways to care for your self and self care will look different for each person. Many of these examples cross over to other categories. It is important to care for yourself in many different aspects of your life. Self care is important to your overall wellbeing. It does not need to take long but even incorporating a few minutes a day or trying one or two examples from above can make a big difference. 

For more ideas on adding self care into your life contact Kull Counseling at 608.239.4807 or julie@kullcounselingmadison.com.

Going back to work after a miscarriage

Miscarriage affects 1 in 4 people. Most miscarriages happen in the first trimester. While it is common to have a miscarriage, how it affects you looks different for each person. A miscarriage can take a toll on your wellbeing. Many women struggle with how and when to return to work after having a miscarriage. Below are some considerations for deciding when to go back to work and some coping tips that may be useful at work.

Considerations to make before returning to work:

1. Is your body physically able to return to work?

Having a miscarriage can be a painful experience. It can drain you not only emotionally but physically. It is common that your hormones may be out of whack and is common that you will still have pregnancy symptoms and you may still feel pregnant. The miscarriage may take a few weeks to complete. You may need to take time away to schedule a D & C. You may need to consider what your job asks of you physically. Do you have to do any heavy lifting or be on your feet all day?

2. Are you emotionally ready to return to work?

Do you feel well enough emotionally ready to return to work? You might be having a hard time concentrating. You also may find that your emotions are consuming you. It is common to feel like your emotions are on a roller coaster often feeling more than one emotion at a time. It is common to feel sadness, anxiety, depression, loss of interest in things, isolated, and feeling disconnected from your body.

3. Will you tell anyone?

If you took some time off after/during your miscarriage your boss may wonder while you are out. Will you tell your boss? Have you thought about how you want to tell them? If you decide not to talk about it at work have you thought about what you might tell your coworkers if they ask where you were. Do you have anyone at work that you can trust or that your feel like you want to tell?

4. What can you do if you are feeling upset at work?

When you have a miscarriage it can affect you at different times. You might be feeling okay but then something may trigger thoughts of the miscarriage and feelings of sadness, frustration, isolation ect. Do you have coping skills at work when these feelings come on? Is their someone that you can talk to? Would you like some alone time? Where can you go? Your office, a bathroom, outside for a walk? Does deep breathing help you? A simple method is called four square breathing. Breathe in to the count of four, hold it to the count of four, exhale to the count of four, hold it and repeat. Can you do a grounding exercise? An exercise that is easy to remember is to just feel your feet. Put your feet flat on the floor and bring awareness to any sensations that you feel in your feet for the next minute.

5. When do you have to be back at work?

Do you know your work policies about how much time you can take off this may include bereavement leave or your company may even have a policy around pregnancy loss? Have you contacted the correct departments if you need more time off of work. Most companies have a human resources department that can help to guide you through this process. Can you work from home?

If you do not feel ready to return to work it is important to speak with your doctor. If you are feeling depressed or anxious most days it is also important to talk to your doctor or identify a psychotherapist that you can talk to.

For tips on returning to work and early pregnancy loss contact Kull Counseling, LLC at 608.239.4807.