Ep 232: Anxiety and Pregnancy with Dr. Lauren Cook

Dr. Nicole (00:00): This is a really informative episode with Dr. Lauren Cook about an important topic that we don't talk about enough anxiety. Welcome to the All About Pregnancy and birth podcast. I'm Dr. Nicole Calloway, Rankins, a board certified OBGYN, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it.

(00:55): Hello there. Welcome to another episode of the podcast. This is episode number 232. Whether you are a new listener or returning listener, I am so grateful that you're spending some time with me today. In today's episode, we have Dr. Lauren Cook. Dr. Cook is a licensed clinical psychologist, a company consultant, author, and speaker. She has a doctorate in clinical psychology and a Master's in Marriage and Family Therapy. Dr. Lauren appears frequently in the media to provide commentary while also working with companies as well as individual adults, couples, families, and teens to help reduce anxiety and improve personal and professional outcomes. Dr. Lauren owns a private practice, hardship, psychological services that serves clients residing in California, and you can connect with her through TikTok. She has over 240,000 followers there, as well as Instagram, her Brain Health Book Club, and her podcast, the Boardroom Brain. Also, she recently released a book that she wrote called Generation Anxiety, so you can check that out as well.

(02:08): We have a really informative and helpful conversation when we chat about what is the definition of anxiety. This is a really important thing to really understand what we mean when we say anxiety. We talk about how anxiety is different from stress. I ask her whether or not some level anxiety is actually okay. You may be surprised at her answer. We talk about why we see an increase in anxiety, the events that have led to this, of course, how anxiety manifests during pregnancy and postpartum. We also touched upon her interesting phobia that she has a meta phobia, which is a phobia of vomit, and she talks about how she overcame that. And then of course, some practical advice on how to deal with anxiety during pregnancy in the postpartum period. So as always, you're going to find this episode super duper helpful. Of course, one of the things that can help produce anxiety around childbirth is education.

(03:05): It is one of the most important things, in fact, to help reduce anxiety surrounding childbirth, and I have a fantastic option to help you with that with childbirth education. It's called the Birth Preparation course. It's my signature online childbirth education class that will get you calm, confident, and empowered to have a beautiful birth with a focus on hospital birth. That's what I know, and that's what I teach quite well. Thank you very much. Inside the birth preparation course, it covers everything from how to get in the right mindset for your birth. In fact, that's what we start out with because that's so important in order to help you really set the tone for your birth, and then of course, all the details of labor and birth, the things that are happening in your body, what to expect in the hospital, how to advocate for yourself and more. You can check out all the details of the birth preparation course at drnicolerankins.com/enroll. I would love to see you there. Okay. Let's get into the conversation with Dr. Lauren Cook. Thank you so much, Dr. Cook, for agreeing to come onto the podcast. I am excited to talk about this topic. I think it's one that we don't talk about enough.

Dr. Lauren Cook (04:16): I agree. I'm so glad you're given the space for it, Dr. Nicole. So thanks for having me.

Dr. Nicole (04:20): Yeah. So why don't you start off by telling us a bit about yourself and your work and your family, if you'd like.

Dr. Lauren Cook (04:26): Sounds good. So I have to start by saying I'm a new mom. I have old as of today, little Derek. It has been such an exciting ride. Also very open about my own anxieties that I've experienced throughout the pregnancy and now as a new mom.

Dr. Nicole (04:44): And

Dr. Lauren Cook (04:44): In my daily practice, I'm a licensed clinical psychologist, so I have a practice here in California, and I work with a lot of companies and teams too, to talk about how we can bring more mental health to the workplace. So very excited to talk all things anxiety with you today. My new book Generation Anxiety just came out, and I think it's something that many of us really struggle with on a pretty regular basis.

Dr. Nicole (05:07): Sure, sure. Absolutely, absolutely. Now, before we get into the topic, I would love for you to take a moment and tell us about what training you've gone through to do this. I asked that question because there are so many people on social media and not that people without specific sort of training, not that they don't have something to contribute, but I always want people to know who they're getting information from and what training and background they've had. So what type of training have you gone through? I'm

Dr. Lauren Cook (05:33): So glad you asked that. So I have my Master's in Marriage and Family Therapy from USC. I went to UCLA for undergrad, so I hesitantly say tro, and I have my doctorate in clinical psychology. I have a side D. A lot of people aren't necessarily familiar with the difference between a PhD or a PS D. They're both doctorates. But A side D, I'd say is more of a focus on clinical training. So obviously we love and appreciate research. We did dissertations as well, but we really are focused on that piece of working hands-on with our clients and not just doing the research in the lab per se. Sure,

Dr. Nicole (06:10): Sure, sure. And then I should ask to stay in practice, I assume you have to be licensed and all of those things, so there are some requirements there as well.

Dr. Lauren Cook (06:19): Oh, yeah. 3000 hours to get licensed national exam, California exam, I just renewed my license actually for the state of California. And a little side tangent, because I think this is really interesting for people looking for providers with therapists post pandemic, we really are starting to see so much more virtual support provided called pact. So it's still not quite there yet, but I think what we're going to start seeing is that you can work with providers in different states. So it may come down the home front where I'm able to work with somebody in Virginia, for example. So people should stay tuned for that. Okay.

Dr. Nicole (06:56): Awesome. So thanks for sharing. So that means summary. You've gone through a lot of training and have a lot of expertise and experience in doing this work. Yes. So why don't we start off with just the basics. What is the definition of anxiety?

Dr. Lauren Cook (07:09): Yeah, so anxiety really at its core, it's about wanting control, and often the more we crave control, the more out of control We feel. One of the hallmarks of anxiety versus, Hey, I feel really stressed. What's the difference? Does the worry feel out of control? Because we all have different worries or finances, what's on the calendar for this week? But does it feel like your mind is a hamster on a wheel cannot stop. That can really be an indicator that it may be something like generalized anxiety that's going on. And if we notice any kind of avoidant patterns happening in our lives where we start canceling on people, we're staying inside more and more. That could really be a sign that the anxiety is starting to really take a grip on us.

Dr. Nicole (07:54): Gotcha, gotcha, gotcha. Now, is some level of anxiety considered okay, or even considered normal?

Dr. Lauren Cook (08:05): Well, I always like to bring in what we call the four Ds. I didn't make this up, I learned it first from Dr. Henderson, so credit goes to him. But really these are the four key things to take note of. One is if there's any kind of deviance, and what I mean by that, if we're looking at a bell curve, is there deviance from your norm? Like you are noticing, Ooh, I'm really feeling a surge in symptoms that I haven't normally noticed. Or deviance too. When we're looking at our peers, I'm noticing that I'm having these panic attacks when I'm going out to a restaurant, for example, it doesn't look like the people around me are experiencing those symptoms too. So there's deviance, right? There's distress. Are you worried about how much you're worrying? Right? We call that meta worrying. Is there any kind of dysfunction?

(08:50): Are you not able to show up to your job in the way you'd like to? Are you feeling like you can't keep up with your commitments in your life? And we've got to normalize this last one. Is there any sense of danger? And what I mean by that is do you feel like you can't keep yourself safe? Are you having thoughts like, oh, it'd be really nice to not wake up tomorrow, or are you having thoughts about hurting someone else? Four dss? If you notice those things are going on for you, that's a really good indicator of, okay, I would really benefit from getting some additional support with this.

Dr. Nicole (09:23): Gotcha, gotcha. So it sounds like stress. Stress is a normal part of life. It's true. But when that starts to impact the way that we function, the way that we show up, if it's different than when you see how other people are doing things, when that meta worrying you said, comes into play, then we need to start being concerned.

Dr. Lauren Cook (09:43): Yes. Yes, absolutely.

Dr. Nicole (09:45): Okay. Okay. So it feels like we're seeing an increase in anxiety. So is that true? And if so, why is that the case?

Dr. Lauren Cook (09:55): It's definitely true. So we are seeing both increase in prevalence, meaning more and more people. Anxiety is the most common mental health diagnosis actually, of anything that we see. 40 million Americans experience anxiety

Dr. Nicole (10:09): Also even more than depression?

Dr. Lauren Cook (10:10): Yes. Oh, yeah.

Dr. Nicole (10:11): Yeah.

Dr. Lauren Cook (10:12): Okay. So depression is close behind, and a lot of times there's comorbidity, right? Between anxiety, absolutely. But anxiety actually takes the cake that we don't want in that sense. But we're also seeing an increase in severity of symptoms as well. So the anxiety is more intense for people, and that can look like so many different ways. For some of us, it's panic attacks, generalized anxiety, social anxiety. I've really seen that one really spike up coming up pandemic. There's a lot of ways this can look, even separation anxiety, which is something I can see a lot for new moms and parents. It's not just our kids that maybe have a hard time leaving us when they go to daycare. We may have a really hard time leaving our kiddos, and that can involve anxiety too. Sure,

Dr. Nicole (10:56): Sure. And then why do you think that is?

Dr. Lauren Cook (10:59): Especially with the book coming out Generation Anxiety, people have said, well, other generations have seemingly had it so much worse. Like with World War II and things like that, why are these generations struggling more? So I really think one of the biggest contributors to it and the American Psychological Association, their Stress in America survey, which I really recommend everybody look up, it's really fascinating data talks about how 75% of young adults feel unsafe in the United States every single day. And this question for you, Dr. Nicole, do you have any guess what people say is the number one fear they have living in this country

Dr. Nicole (11:39): Being shot gun violence?

Dr. Lauren Cook (11:43): Exactly.

(11:44): 75% of young adults say that gun violence is their biggest fear. And now as a new parent, this is a huge fear for parents too. Don't feel safe dropping our kids off at school. So there's just this constant heightened level of anxiety. And then there's also anxiety about the future too. When we look at climate change, so many of us have been affected either, I know so many people living in California whose homes have burned down, and that happens so quickly. The world feels very unsafe and unpredictable. And so I think that is really contributing to a lot of the anxiety that we're seeing.

Dr. Nicole (12:18): Gotcha. Well, I have to ask, what do you think is the contribution of social media?

Dr. Lauren Cook (12:22): Oh, yeah.

Dr. Nicole (12:24): It's

Dr. Lauren Cook (12:25): Almost a low hanging fruit, right? Because it's really such a given at this point that, and I see two sides to every coin. I think in some ways on TikTok, young adults are learning a lot about mental health, which I think can be a good thing in some ways. The flip side though, you have a lot of people, for example, diagnosing themselves with ADHD from watching a 32nd TikTok clip. So that's something too. And we know that for young adults, especially as we're really handling body image and our bodies are changing filters and things like that, and just the direct comparison, how many likes does this person have? How many followers does this person have? And really equating worth in these numbers, that is a recipe to really feel insecure and inadequate in

Dr. Nicole (13:16): Ourselves. Yeah, absolutely. Absolutely. Social media is a blessing and a curse. I mean, it certainly has great aspects and can be very educational, but it can also cause a lot of distress for people. So I think this generation especially is the first generation who's really has been thrown into navigating this and growing up, and really in a big way. So hopefully we'll find some sort of middle ground with social media, but it has its ups and downs and yeah, I agree. It can definitely contribute to anxiety, for sure. Okay. So let's talk about anxiety specifically related to pregnancy and postpartum. So how does anxiety manifest during pregnancy?

Dr. Lauren Cook (14:02): It can show up a lot of different ways. And for me in particular, I've struggled with a meta phobia throughout my life, which is a phobia of vomit, really fun. But did

Dr. Nicole (14:14): You have nausea and vomiting yourself during pregnancy, or did

Dr. Lauren Cook (14:17): You I only threw up one time. Okay. However, I will say this, as a clinician who treats a lot of anxiety and phobia and things like that, I like to take a nuanced approach where I'm very much an advocate for what's called exposure and response prevention therapy, ERP. So I literally worked with a therapist and we would watch videos of people vomiting. That was the work. I also am not of the belief that we need to necessarily just grit our teeth and endure the discomfort fully. So I had a lot of coping mechanisms in place during my pregnancy. I had one of those acupuncture bands, and I took unam in the evenings. So I found a happy medium with how to cope with that. So the anxiety can be very physical for folks, like it was for me, but it can also be more existential.

(15:09): What's really hard about pregnancy? There's so many elements that we can't control with it. And at its core, like I said in the beginning, anxiety is about wanting control. So from the second we decide potentially, oh, I think maybe I want to get pregnant, we have no idea. We may get pregnant that month. It may take a year. It may take a very long time, or it may not happen. And so that out of control element to it is really unnerving for folks. And talk about time, feeling long, those nine months can feel incredibly long for people. Definitely. Because every day you can be holding your breath. So that really can play out in the pregnancy. And it's part of my work is helping my clients learn how to lay back in the metaphorical hammock a little bit, if you will. Try and hold what we can, but also acknowledge what we can't control, and as we can try to make peace with that as hard as that is. Yeah,

Dr. Nicole (16:10): Yeah. Absolutely. Absolutely. So then what about anxiety postpartum?

Dr. Lauren Cook (16:16): Yeah, so people would always tell me like, oh, once you have a baby, your heart is beating outside of your body. And I do think that is true to a very large degree because here's the element of control. Once again, especially as our kids get older, we can't control everything that they're going to do. And in fact, we want them to develop their own healthy independence. Right? Sure. I see that really getting very tricky for a lot of my teen clients. Their parents are tracking every single move that they do, and they don't feel like they have that independent identity. So that can be really tough as new parents is really learning like, Ooh, I'm going to do everything I can to protect this little being. And at the same time, I have to acknowledge what I can't control. And one thing that I love, there's a psychologist named Wincott, and he talks about being the good enough parent.

(17:10): And that is something that I've really tried to integrate as a parent. I'm going to do my best. And at the same time, I'm not going to mentally beat myself up for not doing everything perfectly because that's impossible. And I find a lot of parents, we can get into very rigid scheduling. Everything gets tracked on an app, and we forget our instinctual awareness for how to take care of these little ones. We forget how to trust ourselves, and we forget that we can handle distress and discomfort sometimes as our little ones are understandably figuring out their bodies. So I think that's all things we can hold in this.

Dr. Nicole (17:51): Sure. Now, do you think postpartum anxiety is under recognized? I don't think that it's recognized enough, and people sometimes are often surprised that it was actually anxious thoughts of something that was going to happen bad to the baby. I think my first daughter was born eight weeks premature, and she had a intestinal malformation. She was in the nicu, and when she came home, I 1000% had anxiety about every little time she threw up or something, I was like, this is something's wrong. So I didn't realize that at the time that it was probably just postpartum anxiety. So what are your thoughts about how we treat or recognize postpartum anxiety?

Dr. Lauren Cook (18:35): I think we definitely don't ask about it enough. And even anecdotally, being in the hospital, working with my OB GY definitely got asked about depression, and we heard about postpartum depression a lot. But from my research, postpartum anxiety is actually more prevalent. And I think sometimes it really gets brushed aside as like, oh, well, this is just part of being a new mom. But really if we find that folks aren't able to leave their house, if folks are finding that they're just having ruminating thoughts all the time where they're just spending hours on Google each day researching different things, a lot of times it can almost manifest a little bit more like OCD in some ways where there can be excessive checking behavior. So we are having these anxious thoughts, and then we're wanting to carry out these sometimes compulsive behaviors,

Dr. Nicole (19:25): Like constantly checking the monitor, making sure the baby's breathing, those kinds of things. Yes,

Dr. Lauren Cook (19:31): Exactly.

Dr. Nicole (19:32): Exactly. So for someone who's experiencing anxiety during pregnancy or postpartum, let's shift to some strategies to help. So what are two or three things that you think are helpful to deal with anxiety? And if you want to separate it out, pregnancy versus postpartum, that's great, but if they're all the same, just go for it.

Dr. Lauren Cook (19:51): Okay. Sounds good. So this one may be a little bit surprising to folks, but utilize the power of distraction. We often are told that distraction is a bad thing. However, when we're in a really active state of distress, whether we're feeling panicky or we're feeling physically uncomfortable during the pregnancy, the mind when it sits in those symptoms can actually really exacerbate the pain in the body. So I literally, I'm not kidding. I got to level 600 of Candy Crush during my pregnancy

(20:23): When I would feel nauseous or I'd feel anxious. I just needed that mental distraction, and it really did help in that moment. Another thing that's really helpful is if we can shift environment sometimes. So getting some fresh air for five minutes, trying to move our bodies ever so gently. Sometimes movement can be really, really tough. I had very bad pubis synthesis, pain at the end, my pregnancy, but just getting some fresh air can be really, really helpful for folks. This one may be not so surprising, but mindfulness practices are huge. Really recentering on the breath. I remember being in the hospital after Derek was born. I love the Hypnobirthing app. And just listening to her voice reminding me to focus on the breath when life just felt like it had been turned upside down on its head, was so helpful. And the last tip I'll share is because a lot of us, we struggle with people pleasing.

(21:23): I definitely, I ended up hiring a doula because I wanted to help someone to help me advocate for myself in different spaces, but really getting comfortable sometimes saying no to people. And we hear a lot take in help, and I think that's true, but sometimes we need our own time for ourselves. And that may look like saying to mom, you know what, Hey, I just need to be home alone with the baby for a while with my partner, or no, I can't take on this extra thing, whatever that may look like, and not add on the guilt if we need to do that.

Dr. Nicole (21:57): Gotcha. Gotcha. And then what about the role of therapy during pregnancy and or postpartum?

Dr. Lauren Cook (22:03): I'm such an advocate for it, and I'm not just saying that because I'm a therapist. It's really nice to be able to get the thoughts outside of our heads and to say the words out loud, just that act alone can be incredibly healing for people. And sometimes it's really nice to have somebody who's not in our immediate world, someone who doesn't have a horse in the race to just be there in the experience with us. And it's a non-judgmental space. That being said, I'm a huge advocate for holistic healing, that we can't just heal from the neck up. So for me, working with my naturopathic provider was very, very helpful with taking supplements that helped me with my particular balance, such an advocate for people getting their blood work done, because the body has powerful data, and sometimes we can feel very anxious when it really may be a vitamin D deficiency, for example. So it's very important that we take into account our holistic healing. Absolutely. And not just from the neck

Dr. Nicole (23:04): Up. Yeah, for sure. For sure. Now, do you think there's a benefit in looking for a specific, like a therapist who specializes in reproductive health, or is there additional training? Sometimes I see folks say that they focus in reproductive health. Is that just a personal interest or are there options to get more training in that kind of thing?

Dr. Lauren Cook (23:24): So to my knowledge, there isn't necessarily a specific certification in that way. There is, for example, for somebody who provides EMDR, which is a trauma-based therapy. And I know a lot of moms who have really benefited from EMDR if they've had a traumatic birth, that would be a recommendation I would make sure. But we all are required to do continuing education credits, and there can be folks who they really want their specialty to be in perinatal work. Gotcha. So you will know if you're going to a provider that focuses in that. They certainly have more experience in that than the average clinician and that they're certainly passionate about it, which is important too.

Dr. Nicole (24:03): Yeah, definitely. Definitely. So when do you think someone should consider medication for anxiety, especially during pregnancy, which can be controversial or maybe people have hesitations about medication. And I know you don't assume you don't prescribe medication, so what are your thoughts about that?

Dr. Lauren Cook (24:22): You're right. I'm not a psychiatrist, so I don't prescribe medication. This is something I really recommend talking to your ob gyn about different medications treat different things. From my understanding of the research, taking something like an antidepressant during pregnancy has been shown to be safe in that way. Of course, talk to your doctor about that. However, there is mixed research on something like taking Klonopin, Xanax, things like that for panic attacks. And the research does show that long-term pregnant or not. That is something that we try and find other ways to cope just in that sometimes those medications can be addictive and actually can reinforce the panic where the person can feel like if I don't have access to the Xanax, for example, I'm going to have an even bigger panic attack. So that's where it's really helpful to be working with a therapist to have other alternative coping mechanisms in place. But at the end of the day, talk to your ob gyn about it, talk to your general practitioner. It's going to look a little bit different for everyone too, depending on how severe the symptoms may be. Okay.

Dr. Nicole (25:28): Okay. All right. And I guess that's the same for breastfeeding also, when people, after they have a baby, whether or not what medications or they want to consider with breastfeeding, same thing.

Dr. Lauren Cook (25:39): Same thing, same thing. Talk to your doctor about what's going to be most effective for you. At the end of the day, mental health of the mom is the most important thing. If you feel like you are not able to take care of your child in the way that you want to because of, and there's never any blame or shame, if we are struggling with our mental health, then that's something that we've got to address. And I think we really just need to normalize that so many people struggle with this, and it's okay to talk about it.

Dr. Nicole (26:07): Sure, absolutely. Now, I usually send folks questions at a time that I'm thinking about, and a couple just popped into my head, so I'm just going to ask, so is are there any particular myths about anxiety that you really wish people would just let go of or false information about anxiety that you're like, can we please stop saying this?

Dr. Lauren Cook (26:30): That's such a fun question. I mean, I will say this, and this may be potentially disappointing to people to hear at first, but then ultimately, hopefully liberating. It's not about making our anxiety go away. In fact, a lot of the time, your anxiety is not going to go away. It's about learning how to live with the anxiety. This is something I write a lot about in the book, in that it's not about trying to just be free of anxiety. Our human brains won't really allow for that. And actually, the more we try and suppress the anxiety, the bigger it tries to become. So when we can actually accept and say, yeah, I feel anxious, whatcha going to do about it? It really deflates the power of it, the fear that we have over it. And so I hope a narrative we can start changing that it's okay to feel anxious and we don't need to let it stop us from living the lives that we want to live.

Dr. Nicole (27:25): That's a really, really important point because I think so much there's a natural urge to want to make this thing go away, want to not have it anymore. I totally get that. But the reality, like you said, is that it is something that you may just or you will have to learn to coexist with and that it doesn't control you, so to speak. Control as much as you can control. For sure. And then my next question is, after going through pregnancy and now being a new mom, how do you think that has informed your work about anxiety and how you approach taking care of your patients? I know for me, certainly having a preterm birth and a NICU baby and all of those things certainly changed the way that I approach medicine. So do you think that now having pregnancy and a birth and being postpartum, how has that changed you in the way you approach your

Dr. Lauren Cook (28:23): Work? I mean, I think I had empathy and compassion before having a baby, but I really feel like that's gone times tense since having a baby. This stuff is really, really hard. It's not easy to do this. And yet something I try and remind for myself and something I try and hold for my clients too, is what are your values? What is meaningful to you in life? And how can we help you live out those values even though you do feel anxious sometimes I think it could have been very easy for me to go through my life and say, well, having a baby is too hard. I'm too anxious, so I'm just not going to do it. And I really had to ask myself the regret question, would I get to the end of my life and feel regret about not experiencing this? The answer was yes. And so to me that told me, alright, let's start to sit with the discomfort of what pregnancy, what childbirth, what parenting could be, because ultimately at the end of the day, these are my values. That being said, it's still really hard and scary sometimes. And so I have so much honestly respect for people who are willing to be uncomfortable because the easy choice is to not have kids, to

Dr. Nicole (29:37): Not do this. That

Dr. Lauren Cook (29:39): Is the easy choice in a lot of ways. And yet for those of us who choose to do it, we choose to do it because we want to. We're not letting our anxiety win. So I have mad respect for people who jump into the pool of parenthood now that I'm in the pool myself. It's not easy, but it's worth it. Yeah,

Dr. Nicole (29:58): It is. It is. It is. And also, I want to ask, do you feel like your doula was helpful? I'm a big supporter of doula, so I always like to, if people have experiences with doulas. Do you feel like your doula was helpful in mitigate or decreasing any anxiety around your birth experience?

Dr. Lauren Cook (30:13): Oh, I love that question. Shout out to Bridgett who I adore. So I have a really interesting birth experience in that I ended up having a breach baby.

Dr. Nicole (30:25): We

Dr. Lauren Cook (30:25): Could talk more about. I really feel like it's much more common than the one to 3%.

Dr. Nicole (30:31): It's

Dr. Lauren Cook (30:31): Like four of us in my mommy and me class out of 10 that had breach babies. Isn't that interesting?

Dr. Nicole (30:37): That is interesting.

Dr. Lauren Cook (30:38): So Bridget was absolutely incredible because I ended up having a plan, but she talked me through the step-by-step process of what to expect with a plan. She also talked me through the decision of whether or not to do the ECB procedure. I ultimately decided not to do it. I felt like this baby's not turning. He's sitting this way for a reason. And sure enough, when he was born, my doctor was like, yeah, he would not have turned in your particular case. And I felt I was so surprised because I do tend to run really anxious. I felt such a resounding peace during the birth experience, and I really attribute a lot of that to Bridget because she did help me prepare so much. And one of our mantras in our work was surrender, surrender, surrender. And that helped me not fight the process so much.

Dr. Nicole (31:32): Yeah. Yeah. Only thing some of the things that I always talk about, birth is very unpredictable. The only thing we can predict is that it'll be unpredictable, and all you can control is the things that you can control. There's so much about the process where the baby is in control and they don't tell us what they plan to do, or they just decide that they're going to do a certain thing. So that's great to hear that preparation is so important to help you. It helps you know that you did all you could do and brought your best self to the process, and that helps people. I believe it helps people to feel better even when things don't go exactly as they anticipated.

Dr. Lauren Cook (32:18): Yes, I agree. And yeah, I'd advocate for a doula all day every day.

Dr. Nicole (32:25): All right. Well then as we wrap up, what would you say is the most frustrating part of your work?

Dr. Lauren Cook (32:33): I would say therapy. I think sometimes people go to therapy and think it's going to be getting a relaxing massage that, oh, this felt so nice. And really, I share to my clients, I'm a little bit more like a mental fitness trainer, and sometimes that means you're going to leave our sessions or workouts, if you will, a little bit sore in that emotionally we're doing some tough work. And ultimately I really want my clients to feel like they decide how much they put their foot on the gas pedal. I want to find that nice balance of helping my clients feel like they're being challenged and still being comforted at the same time. And so I do think that's something that we need to talk more about with therapy, that it's great growth and sometimes it's pain as those emotional muscles get stretched too at the same

Dr. Nicole (33:25): Time. Yeah, definitely. Definitely. So then on the flip side, what's the most rewarding part of your work?

Dr. Lauren Cook (33:30): People are so resilient, and I feel like resilient is a word we hear all the time, but people really do have a lot of grit. And people would say to me like, wasn't it so depressing being a therapist? How do you deal with hearing people's stories all day? But I actually have never been more inspired by humanity than since I became a therapist. People are amazing the way that they ride out the storms of their lives. And the other thing too is I find it very comforting, and I always try and share this with people. When you see what happens behind a therapy door, you realize we are all weird, wacky, goofy people trying to act like we know what's going on, but we all are kind of like little goofballs trying to through our day. Hundred

Dr. Nicole (34:23): Percent.

Dr. Lauren Cook (34:24): I think we would all stop trying so hard if we knew really what's behind the curtain in our lives.

Dr. Nicole (34:30): Yeah, for sure. Definitely, definitely. And you know what I realize, I don't know why all these questions are popping into my brain, but I have one more question. I love it. What is the difference between therapy and coaching? We see lots of coaches popping up these days, so let's just talk for a second about therapy versus coaching.

Dr. Lauren Cook (34:47): Yeah, no, that's a great question. I do provide some career coaching, which is very separate than my work as a clinician. For example, with coaching, you do want to find someone who specializes in a niche, whether that's career coaching, it may look like parenting coaching, for example, but they tend to be giving you specific skills. When I'm doing career coaching, for example, I'm looking at a resume with a client, we're looking at job opportunities. We're not getting into the emotional exploration, for example, for why they may be feeling like they want a career change. So it's very typically skill-based, whereas therapy, oftentimes we're doing deeper dive processing into the why, what happened for why we're experiencing these symptoms, and how can we help you function better day to day so that you are able to navigate when these symptoms do pop

Dr. Nicole (35:38): Up. Yeah, yeah. So what then would be your one favorite piece of advice that you would give to someone who's pregnant now?

Dr. Lauren Cook (35:45): Oh my goodness. That is a big, big question. We were just talking about this in my Mommy and Me class today, which I highly recommend for folks to get involved with a community because so many people in the class have said, I don't know other moms who are at this season of life. And so find other people who are in it with you. And I would say to embrace all the feelings that come with this journey, like the highs, the lows don't should yourself into telling yourself, I should be feeling a certain way about this. You feel the way that you do, and that's okay. And we feel all these things at once, right? A lot of times we get into this all or nothing thinking I'm happy or I'm sad. Most of the time we're actually feeling a lot of mix of different emotions. So giving ourselves permission to feel the entirety of those feelings and not try and put ourselves in a box with one singular experience.

Dr. Nicole (36:44): Yeah, definitely. For sure. Alright, so where can people find you, find your book, all of that good, great stuff?

Dr. Lauren Cook (36:49): Yeah, so I'm at dr lauren cook.com. Generation Anxiety just came out last week, although it might be out for a few months by the time this comes out. So you can buy it wherever you like to get your books. And I'm on Instagram and tiktok at drlaurencook.com, and if you love to read with us, I'll add this in. I host a brain health book club, so every month we pick a new book relating to personal development. Almost always the authors join us. So if you love to read and you want to grow in that way, come join us.

Dr. Nicole (37:19): Nice. I love it. I love it. Well, thank you so much for coming onto the podcast talking about this really important topic. It was so, so helpful.

Dr. Lauren Cook (37:26): Thank you, Dr. Nicole.

Dr. Nicole (37:35): Okay. Wasn't that a great episode? I so appreciate her coming on and breaking down some of those important things about anxiety. It's something that we really, really don't talk about enough and we need to talk about it more. And also, I really appreciate those practical tips as well. Now, after every episode when I have a guest on, I do something called Dr. Nicole's notes where I talk about my top takeaways from the conversation. Here are my Dr. Nicole's notes from my conversation with Dr. Lauren. Number one, I say this quite a bit actually, and I'm going to say it again, control the things that you can control. Dr. Lauren makes a very important point about from the very beginning, there's so much about pregnancy and birth that is not controllable. You can't control exactly when you get pregnant all the way up to how you give birth.

(38:28): The thing of course, that you can control is how you prepare yourself, how you treat, how you educate yourself. Education is something you absolutely can control. Of course, you're doing that by listening to this podcast, which I love and appreciate. But if you really want to take it to the next level, then check out a structured childbirth education program. Of course, I have the birth preparation course. You can check that out@drnicolerankins.com/enroll. But there are other childbirth education options out there. It's just most important that you do something that is a hill that I will die on, that everybody needs to do childbirth education. So I'd love to have you inside the birth preparation course, but find something because it's so, so important. Okay, number two, the concept she talked about of being the good enough parent, really just hit home. I'm going to tell you something, whether it's during your pregnancy or whether it's being a parent, you're going to mess up because we're humans and humans mess up.

(39:30): We are not perfect. Things happen. You're not necessarily going to do everything you wanted to do in terms of eating well during pregnancy or exercising during pregnancy. And when you're a parent, you are going to make mistakes. You are going to do things that you wish you would've done differently. Give yourself some grace. Cut yourself some slack. Know that we are all human despite what we see on social media and very curated things. We're not perfect. And people make mistakes. Give yourself some grace. Apologize. Deal with it. Think about it. Look at the situation, but don't beat yourself up about it. Okay? You're going to mess up. The sooner we can all accept that, not just as a parent but in our lives and deal with that, the better off we will all be. Okay, the last thing I want to talk about is that concept of holistic healing.

(40:23): This is really important and something that is really underutilized in the field of obstetrics and how we connect with other people who can help provide a great pregnancy and birth care in a holistic way. And I'm talking about things like connecting with the pelvic physical therapist. I learned the other day, I don't know if I was reading it on Instagram or reading an article, but in France, every person who has a baby, after they have the baby, they automatically receive a referral to a pelvic physical therapist. Isn't that crazy? We don't do that in the United States, or things like working with a lactation consultant and making that automatic for people who want to breastfeed. We as OBGYNs, we get very, very little. Really no training to be quite honest on helping people with breastfeeding. You're not going to see your OB GYN for six weeks afterwards, typically, even though we're trying to change that, that hasn't changed universally.

(41:20): So really connecting with someone like a lactation consultant working with a chiropractor. Some women swear by working with a chiropractor during pregnancy and a postpartum to help with things like pelvic synthesis, pain, or discomforts. Of course, you want to look for someone who's licensed and who has experience with doing chiropractic care and pregnant folks. But again, that's another area of holistic healing that we don't touch upon acupuncture. Another one is an area where we don't necessarily touch upon. So I love the concept of having a more holistic approach to pregnancy, to birth really to health and to healing in general. All right, so that's it for this episode. There you have it. Do share this podcast with a friend. I appreciate it. I'm on a mission to reach and serve. Many pregnant folks ask I can. And when you share this podcast, it helps me to do that, and I appreciate you doing so.

(42:12): Also, subscribe to the podcast wherever you're listening to me right now, and I'd so appreciate you leaving a five-star review in Apple Podcast. If you like the podcast, I love to hear what you think about the show, and it helps other folks to find the show, helps the show to grow. Also, shoot me a message on Instagram. I'm on Instagram and Dr. Nicole Rankins. You can also reach out to me there and do check out the birth preparation course. That's my childbirth education class that gets you calm, confident, and empowered to have a beautiful birth. You can check out all the details at drnicolerankins.com/enroll. So that's it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.