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.

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

Resources for Pregnancy after a Loss in Madison, Wisconsin - Doula

For this month’s blog post I wanted to take this opportunity to talk to you about how a doula can help with the birth process. It is common when you’re pregnant after a loss to feel an increased amount of anxiety about giving birth. A doula can help with the emotional and physical side of labor.

For this article I interviewed Alli Ryan from Lumos

Julie: So Alli what is a doula?

Alli: A doula provides physical, emotional and informational support. Most folks think that is just to a pregnant person thats giving birth but a doula can extend into birth and postpartum. At a birth we may help you with coping strategies, with positions, we’re going to help you with if your planning a hospital birth so we can navigate some of the hospital systems stuff and know what are your choices, but we can do those same things in pregnancy. We are not medical care providers we don’t give medical advice. We are not midwives- midwives are medical and emotional. As our doula our role is just informational, physical and emotional support.

Julie: How can you help support someone that pregnant after a loss?

Alli: Leaning into that emotional support peace. All people come into birth with a story and sometimes you know what your story is because you have had early pregnancy loss or loss at any point so those emotions are really big. It is finding a safe space. The hormone in labor is oxytocin and oxytocin is the hormone of feeling safe and supported. The way our brain is structured the fear hormones actually compete with our labor hormones. To be able to have someone to set you up to feel safe in not only pregnancy but labor really does allow those hormones to flow a little bit better. It is someone that understands you. We can help you move the staff through so you don’t have to tell your story over and over again. We help you to know what your options are. There can be options available specific to pregnancy after loss such as labor positions that might bring up a lot of feelings for you. We find their are stages along the way like oh I did not realize I had put a lot of energy into getting past 20 weeks or in that ultrasound in our last pregnancy is when things got hard. It is helping you move through some of those milestones. Usually folks that want doula support want all of their feelings honored. They also want information, support and facts.

Julie: Are their commonalities that you see in the labor and delivery room for people pregnant after a loss?

Alli: Moving through pregnancy their are these milestones that you have to get through like I knew I was going to have a hard time getting through that. We can help you think about those things ahead of time, move through those things and coming up with a plan. Sometimes I will find early labor can feel like some of those sensations of an early pregnancy loss and so having a person you can call and say I am having really hard feelings, we aren’t necessarily going to be there to fix them and this is where mental health providers can help with tools but we can be those safe people to help remind you of what your tools are when all of that kind of goes out the window. We can help you bring in your past losses so if you named your babies or put some sort of energy or labels or icons or symbols or teddy bears we can normalize that. That is very normal. It is very normal to help you feel connection in those experiences.

I also think most folks don’t understand how hard the postpartum is.

There can be a big huge wave of grief that comes in waves because you start to realize what you lost in a way that is like in your arms. Their can be a lot of complicated feelings. To lean into the support team that you have created, those are all really important things to do.

Julie: That’s such a good point. I also feel that people are hesitant to have a doula in the room because they are very private and it can be hard enough to be in front of your medical team. Can you speak to that?

Alli: We hear that from a lot from all folks not just from people pregnant after a loss. What we hear now is that a doula actually hear that a doula helps keep things private. We aren’t a stranger thats a weirdo in the room. We’ve also been to a lot of births. If you guys need us to disappear for a while because you need a moment we are going to know that without you even saying it and we are going to kind of blend into the background. We’re also going to in particular in a hospital environment we are going to help that hospital feel more private. We may be able to communicate to stay hey they are just going to have a little time together and can we keep folks out and help you ask for that as a patient. Advocate for what you need. Helping that environment feel like your nest, this is your experience and not a sterile hospital room. There are simple things we can do like turning down the lights and bringing twinkle lights and having is smell different and thinking about your music. But there is also a lot that just comes with our presence a doula in and of itself is a communication tool that we want this labor to take into account our emotions. We want it to feel like an individual experience. We want to understand what is happening around us and we want support. Just having a doula present makes that experience a little more private.

Julie: Do you want to speak why you are interested in working with pregnancy after loss?

Alli: I had been a doula for a couple of years, my husband and I hadn’t had any complications getting pregnant. We seemed to get pregnant very easily but we weren’t able to stay pregnant very easily. My big rainbow, we use the terminology rainbow at our house, pregnancy after loss, was born and then got pregnant again and then almost term we had our daughter who was born via stillbirth. She is a huge part of our life, her name is Vivian and pretty quickly realized that was going to transform the birth work and postpartum work that I was already doing. So I come to doula work in a way that is believing and trusting that people can figure out there way through it but that we need support to figure our own way through. I don’t come with this perspective of this is how I did it, I come with the perspective that is more I understand how hard this is to do this, there are a lot of great professionals in our community that can understand that whether or not they have had loss, I can understand it in a way that is a little bit different. So, right it transformed my work as a doula and then really did. We also went onto to have another brother, so another rainbow and my work was transformed.

Julie: Thank you for sharing that and willing to be vulnerable. If someone is interested in working with you how can they get in contact with you?

Alli: So I own a business called Lumos you can go to our website at welcometolumos.com. We work with other doulas all who have some level of experience working with all different sorts of families of shapes and sizes. Those that have experienced loss as well.