Ep 264: Postpartum Rage with Dr. Ashurina Ream of Psyched Mommy

Dr. Nicole (00:00): I bet you heard about postpartum depression or even postpartum anxiety, but have you ever heard of postpartum rage? You're going to learn all about it in this episode with Dr. Ashurina Ream of Psyched Mommy.

(00:20): Welcome to the All about Pregnancy and birth podcast. If you're having a baby in the hospital, you are giving birth in a system that too often takes away power from women over what happens in their own bodies. I'm Dr. Nicole Calloway Rankins, a practicing board certified OBGYN, who's had the privilege of helping well over a thousand babies into this world. I've been a doctor for over 20 years, and I'm here to help you take back your power, advocate for yourself, and have the beautiful pregnancy and birth that you deserve. This podcast is for educational purposes only, and it's not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it. Hello there. Welcome to another episode of the podcast. This is episode number 264. Whether this is your first time listening or you have tuned in before, I am so grateful you're spending some of your time with me today.

(01:17): Dr. Ashurina Ream is a licensed clinical psychologist specializing in perinatal mental health. She's also the founder and CEO of Psyched Mommy, the largest social media platform focusing on perinatal mental health, and by largest, I mean over 590,000 followers on Instagram after experiencing limited community support. During her own postpartum journey, Dr. Ream pursued advanced training and certification through postpartum support International as well as the Postpartum Stress Center. Since then, she's been equipping and empowering women to thrive in every season of motherhood and beyond. We have an incredibly informative conversation about what is postpartum anger and rage? How does postpartum anger and rage relate to postpartum depression? What things may make you more susceptible to having postpartum anger or rage? We learn about the cycle of anger, how anger and rage may be a surface indicator of things underneath, and we'll talk about what those underneath things may be.

(02:29): And of course, we talk about things that people can do if they think they have postpartum rage and anger. Postpartum rage and anger isn't something that we talk about enough or really even at all. So I'm really excited that we are diving into this important topic today. Before we get into the episode, let me do a listener shout out. This is to off duty Mermaid and the title of her review said, fantastic resource for a first time mom. And the review says, I'm currently eight months pregnant with my first baby. I started listening to Dr. Nicole's podcast during my first trimester. I'm a former nurse now healthcare quality analyst. I wanted to find a resource with a proper medical background. I rely on science case studies and research when making my healthcare decisions. Dr. Nicole provides that and so much more. Her expertise and compassion shown during her birth story episodes is incredible.

(03:31): I also attended one of her free birth plan courses. She shared a lot of information and answered many questions from myself and other attendees. I am forever grateful for having found this podcast. Thank you, Dr. Nicole. Well, thank you so much off-Duty Mermaid, and I love that name, by the way, for leaving that kind review and Apple Podcast, and I'm so grateful that the resources that I've provided are helpful. Now, if you want to join me in my next live free birth plan class, then head on over to dr nicole rankins.com/birth plan and grab your spot. Okay, let's get into the conversation with Dr. Ream. Thank you, Dr. Ream for agreeing to come onto to the podcast. I'm very excited to have you talk about this topic that I really haven't heard talked about before.

Dr. Ream (04:27): Thank you so much for having me, and I know this is one of those topics that we have to address, right?

Dr. Nicole (04:33): Absolutely, absolutely. So why don't you start off a bit by telling us about yourself and your work and even your family if you'd like.

Dr. Ream (04:40): Okay. I am Dr. Ash Ream. I'm a licensed psychologist in the state of Arizona, and I've been practicing for a little bit more than a decade doing my clinical work. And I always tell people that if you would've told me right out of graduate school that I would be doing this work and working in this perinatal mental health space, I probably wouldn't believe you because that's not what I was doing. I started my career working in eating disorder recovery, and then I worked in as a generalist, and then I worked into health psychology at the hospital, but I became a mom for the first time, and that rocked my world because I experienced postpartum depression and postpartum anxiety, and I was like, no one told me about this. Even in graduate school, no one talked to me about what could happen to me. And for the first time I thought, well, if I'm experiencing this, how many countless patients have experienced this and how many people don't know what's going on with them and think there's something wrong with me? No one else has experienced this. No one's talking about it. So I really refocused and pivoted in my career and started to specialize in perinatal mental health so I could support families that were also walking through this journey. And it's been, I don't think I'll ever go back something I'm really passionate about, and now I've got two little kids myself. So navigating supporting parents that are walking this journey, but also supporting myself and my family.

Dr. Nicole (06:09): Love it, love it, love it. And you have a very large platform that you've created, so you still practice clinically and have the online platform too. Yes.

Dr. Ream (06:20): And it's a balancing act, that's for sure. Yeah,

Dr. Nicole (06:22): Absolutely. So one of the things that's important to me is that anybody with a camera can come on social media and start talking about things without necessarily sharing their background or training. I'm never discounting anyone's personal experience, but I believe people should be transparent about what they're bringing to the things that they're saying. So I would love it if you could share with us what training have you gone through to do the work that

Dr. Ream (06:48): You do? Oh, yeah. I've actually never been asked this. That's great. That's

Dr. Nicole (06:52): Great because everybody and their mama and their sister and their cousins sometimes these days is on the internet saying all kinds of things. So please tell us what your training is.

Dr. Ream (07:03): Yeah, it's been a lot of years of school. I actually started, and I'm from Michigan, currently live in Arizona, back to my bachelor's degree. I was studying biology and psychology as a dual major. I really thought I was going to become a pharmacist or a physician assistant. I was like, I'm not going to become a psychologist. I don't even know who. I took my first abnormal psychology class, and I was like, it's over for me. This is what I'm going to do. So I went on to get my master's degree and my doctorate degree from Midwestern University and wrote my whole dissertation on residential treatment because I was really passionate about really following adolescents and seeing these young human beings going through residential treatment and then being discharged, and I can go on about that forever, but I wrote my whole dissertation on that topic. And then it was when I became a mom that I went back and completed the specialization through Postpartum Support International as a certified perinatal mental health care provider. And I have to keep up with my continuing education with postpartum support international every, was it every year? Every two years. I just submitted 'em. So I'm like, I've been forever a

Dr. Nicole (08:09): While. Right, right. So you obviously take this work seriously. I do. And keep yourself educated and up to date about things that are going on.

Dr. Ream (08:18): Yes, I do. Thank you for asking. No one has ever asked me that.

Dr. Nicole (08:22): Okay. Alright. Yeah, that's an important thing to me because like I said, more Instagram I think is more reasonable, and I'm getting off topic a little bit here. TikTok can be a cesspool of nonsense. I know. It actually, it's frightening actually to see some of the things that are out there. So I just want people to know where people are coming from. And I'm not telling you who to trust, but you're at least going to know what training they have when they are telling you information.

Dr. Ream (08:48): Absolutely. I couldn't agree more.

Dr. Nicole (08:51): So let's get into this topic of postpartum anger rage. I have never heard this talked about before, so please tell us what is that?

Dr. Ream (09:00): Oh my goodness. So this is something I experienced personally, so I have a personal, it really connected deeply with me and a lot of the clients I have met with. And it's one of those things that induces so much shame that people don't want to talk about it because who wants to say, I am experiencing anger and rage as a mom. So what I see clinically that particularly mothers come to me when they say I am more irritable than I ever was, I just feel like everything sets me off. And what I notice, it's on the spectrum from irritability to annoyance, all the way to rage or fury where they're lashing out, yelling, slamming doors. And the thing about it is that it doesn't feel like, I can't say the punishment fits the crime, the small things that might be setting you off. So it seems out of proportion for the situation, and it's typically in most cases when clients are coming to see me, they'll say, I am not an angry person.

(10:00): This is really uncharacteristic of me and I feel like I can't control it. And I remember experiencing this myself with my oldest son where his lack of, if he wouldn't go down for a nap, I would get so angry about it, I would set him down in this bassinet. I would come out of the room and I'm crying, I'm screaming. I'm like, why is this so upsetting to me? And I didn't understand it. I wasn't going to share it with anybody. I thought, who wants to hear about the angry mom? Who wants to hear about the mom who can't get these feelings under control? But then I started to hear the themes and therapy of moms coming in and saying, I've never shared this with anybody, and I want to tell you that I am so angry and I don't know why. So that is a little picture, a little glimpse of what I see in clinical practice in my own experience.

Dr. Nicole (10:50): Gotcha, gotcha. So how does that relate to postpartum depression?

Dr. Ream (10:54): Great question. Oftentimes we see rage as a symptom of postpartum depression or anxiety. It's not always the case. It can stand alone dependent on a number of things, but we typically hear of postpartum depression. We think of the weepy parent, like the parent that's crying, can't get out of bed, but we also have this agitated depression or this irritable depression that we can also see where it just feels, I always have this description where it feels like sandpapers rubbed against your skin and everything that touches you, it feels like it's going to set you off because you have nothing else left to give. And you're wondering, why are these things frustrating me? Why is my kid asking me all these questions frustrating me? Why am I feeling this way? Everybody told me that postpartum depression was this deep sinkhole of depressed dysthymic experiences, but that's not always the case. Okay.

Dr. Nicole (11:51): So you have this beautiful description, and I don't know if it's yours or where it came from, but this cycle of anger that I think really is important to help people understand what is that cycle of anger about?

Dr. Ream (12:01): Yes, this is something I see quite frequently. And so I like to conceptualize things in this way where there's often some kind of triggering event and it can see the most benign situation. Like your partner leaves a dish out on the counter in an rational mind. We're like, that shouldn't set anybody off, but that could be the triggering event. And there is this personalization of the event, whether it's about somebody else or whether it's about yourself. It's like this negative thinking where we say, if it's about a partner, maybe they don't value me. If it's something that you did yourself, maybe it's wrong with me. I'm such a monster. I can't believe I would do that. And then after we have this personalization, there's an emotional experience that happens now we're feeling annoyed, we're feeling frustrated, we're feeling angry, and then this big reaction will follow whether we yell or we maybe curse slam doors, throw something. And that can be really scary to us sometimes when our reaction is so big and we're not used to it, we can almost, it's like we, oh, where did that come from? I didn't even know that was in there. And so on goes the cycle where we're experiencing shame, embarrassment, and now when we're in this shame and embarrassment, we are far more vulnerable to these triggers again. So on goes the cycle, and now the triggering events become more triggering because we have just come off of these experiences of shame and embarrassment.

Dr. Nicole (13:34): Gotcha. Gotcha. That makes perfect sense. Then are there any things that may make someone more susceptible to experiencing postpartum anger or

Dr. Ream (13:44): Rage? Yes. I always say this for myself personally, I am not my best when I'm not sleeping. That is one of my biggest, for myself personally, I know these feelings are going to creep up if I have sustained and chronic sleep deprivation, but it's not just sleep. I think about unmet needs as being a really large portion of these vulnerabilities. I talk about vulnerabilities that can really lower our, it's like the entry point to feelings of anger and rage is so low when our needs are not met for safety, emotional connection, feelings of belonging or fulfillment. So maybe if we're not getting our emotional needs or if we have a history or a presence of trauma, anxiety, depression, or another mental health condition, if we have poor boundaries, this can make us really vulnerable to feelings of rage and anger, stress and burnout, or even overstimulation if we are really sensitive to the sensory input around us, that can also just kind of be this. It's pulls that lever to where we're feeling these feelings far more frequently and far more readily.

Dr. Nicole (14:58): Gotcha. Gotcha. I know one thing I saw, I think I saw on your website that was also interesting is what about if you're raised by parents or raised in an environment where yelling and anger or more common,

Dr. Ream (15:11): It's like this generational cycle that we take on that we don't necessarily want. We find ourselves saying things like, I sound just like my mom, or I sound just like my dad. And those are also vulnerabilities when those just kind of passed on to us, these maladaptive strategies for coping. And one of the things I find in my practice and for my own personal life is when something is happening, and it's like we're something for our own childhood, we don't even realize it. We're like, ah, I am feeling these feelings because this scenario was never allowed in my nuclear home growing up. I always think about this with my own kids, backtalk was not allowed, and I'm getting, listen,

Dr. Nicole (15:56): Okay. No, absolutely not.

Dr. Ream (16:00): You weren't breaking all the rules. That's what I always think to myself, and I'm reparenting myself while I'm parenting my children, and I'm like, this was not allowed. And it's creating this intense frustration inside of me because not only am I trying to teach them something, but I'm trying to just reframe the rules for myself. So

Dr. Nicole (16:21): Yes. Yeah, definitely. That made me laugh because it's like as your children get older, you realize you raise children. You want to raise your children to question things and think about things, but then sometimes you want to be like, because I said so, stop asking me all these questions.

Dr. Ream (16:39): This is my daily. That's my, yes. That is the balance. My daily thing that I go through, it's like, oh, I love your curiosity and the questions and the wanting to push the boundary. I get it. I know this is critical, but not today. Not today. How about tomorrow? Yes.

Dr. Nicole (16:59): Oh, goodness. All right. So one of the things that I thought that was really interesting about what you said is that anger and rage is typically more of this surface indicator of things, and there are things that are deeper underneath it that you may relate to or may think or feel. And I just want to touch through each of those things that you mentioned and see if you can expand upon them a little bit further. So one thing you said that you may also feel this may resonate with you is if you are someone who may be suffering from anger or rage, you feel suffocated by the demands of parenthood. So what is that about?

Dr. Ream (17:38): Yes, and I think this goes back to I talk about anger and rage as like you said, there's a surface experience. And when I go to really teach on what these are, it's a secondary emotion. So anger and rage is like the secondary emotion. It's what we see on the surface, but people around us, that's what they see really. These are often protecting us from what lies underneath. And because they're vulnerable feelings that we don't necessarily, we're not ready to share, we don't want to share. We've been taught to really guard them. So I always tell people it's not bad to feel anger. We should all be experiencing anger because it's a protective emotion. Sure. It tells us often when something is wrong or when a boundaries being violated. So we don't want to escape it completely, but we want to be paying attention to why am I feeling this way?

(18:29): And often sometimes that protective mechanism is kind of like it's showing itself far too frequently, and that's when we have to pay attention to like, okay, what is that vulnerable feeling? That's the primary feeling, the primary emotion that we are trying to conceal and why can't we access it? So often that can be when we are maybe feeling inadequate or we are feeling overwhelmed, we're feeling disappointed in somebody or something, and we're feeling sad, and we access anger so readily because it makes us feel a bit more powerful. It makes us feel that we're in control. So when I say I feel suffocated by the demands of parenthood, oftentimes there's this unfairness that lies underneath it. Things are not being distributed fairly in my life and I'm taking on the burden, and I do feel suffocated because things aren't fair. And I think it's also, it goes back to this unexpected taking up my identity and my leisure time that I did not anticipate. So anger is such so more readily accessible to us than really doing the work to figure out what is that feeling underneath this. Because anger, it's not the end or something that's under, if we peel that onion, we're going to find something else there that we often are not, we're not doing the work to find out because it's too painful. Yeah,

Dr. Nicole (19:53): Definitely. Definitely. So you said another thing that might be when you peel back those layers that you feel let down by those you thought cared about you.

Dr. Ream (20:02): This one's a big one.

Dr. Nicole (20:04): Yes.

Dr. Ream (20:05): This one's a big one. I will say that is one of the bigger things that comes up in therapy is how when the people that we love most are not showing up for us in a way, are supporting us in the way that we expected. It is frustrating and we access anger. But oftentimes there's like I am feeling disappointed, I'm feeling sad, I'm feeling let down by others. And anger is the check engine light that's showing up and saying there's something wrong underneath the surface here that we need to be paying attention to. And often just anger is easier, right? It shows us in others, in our minds, we're thinking, I'm not going to lose control over this. I'm not going to let you get to me. I'm not going to let you see the heart deep down inside. So roo is very protective.

Dr. Nicole (20:53): Definitely. Definitely. And I'm guessing, does this play into expectations of what you think your partner should do for you or in the whole new relationship of being parents?

Dr. Ream (21:04): Yes. That is one of the biggest things that can cause resentment in new parents. The expectation versus the reality of the partnership we go into, and most couples don't have these conversations where they're saying, we're going to have kids and this is what we are going to, let's spell it out. I'm in love. We're good. We have so much fun together. And then the reality of all of the things, and then you're like, this is not fair. Your life hasn't changed one bit. Mine has been turned upside down, and you don't even notice me. And it's not just like my life has been turned upside down. I think oftentimes there is this unfairness that we feel like nothing has changed for you. And it's like you're putting that, it almost feels like your partner, their life is on display for you, and it shows you, it's like a mirror for you to see how much your life has changed.

(21:58): It's not that their life is so unchanged, it's that it reflects back to you where you're like, everything has been turned upside down for me. My body, my aspirations, my goals, my sleep, every single thing, physically, psychologically, spiritually, everything has changed for me. And you're kind of going about this. Nothing has changed for you to some degree. And then there's the distribution of the labor within the home. We didn't discuss this, so now I'm doing so much more and you're not pulling your weight, and I feel resentful, so I'm angry and I'm irritable and it's justifiable. So I don't ever want to minimize that to say we shouldn't feel angry. Just because we feel that way does not mean I want everybody to saw through it,

(22:45): Not experience these feelings. They

(22:47): Just need to be addressed. I think there is a reason we feel the way

Dr. Nicole (22:52): That we feel. Yes, yes. And it's interesting, and this is coming from having been married now for almost 19 years. It's not fun to talk about those little things. Nobody wants to sit down and talk about the distribution of work, blah, blah, blah, blah. But it really ain't fun when it blows up. So if you can just make this space and we'll talk about some strategies, I can tell you when you just talk about things, it can just help. A small thing I'll say is I used to hate it. My husband, his name is Falcon, like the bird. He would leave drawers open just a little tiny bit, and he used to drive me insane, close the closing, all the, and it's like, why don't you just, and then I finally was like, can you just, the drawers, he is like, oh, okay. It's oblivious.

Dr. Ream (23:48): The things that bother your partner will not bother. It's interesting how we are. Yes,

Dr. Nicole (23:53): Yes, yes, yes. So when you just talk about things or that expectation versus reality, it just makes things so much easier. And there's also that expectation versus reality of actually having this human being to take care of, I'm sure.

Dr. Ream (24:08): Oh, yes.

Dr. Nicole (24:10): Because you think, and social media can definitely make it appear like, oh, it's beautiful. There's roses, there's rainbows, and it doesn't necessarily show some of the crying, the poop, the wake up in the middle of the night. So how often do people experience that difference or the gap between those things for having that new baby?

Dr. Ream (24:33): I would say 100% of the people I've ever met with in therapy that are coming to me postpartum have they say That was a shock,

Dr. Nicole (24:40): Really

Dr. Ream (24:41): A shock. I knew it was going to be hard. I didn't know it was going to be this hard. And they're almost because this portrayal on social media, but on TV or my mother-in-law, and my mother always said, I raised you. I mean obviously it's been 35 years, so they're just oblivious. They just don't even remember going to, we do our best to suppress. We're not trying to hold on to those memories.

(25:10): And I thought this myself, my oldest son was a very colicky. He cried night and day. He cried for, I am not even exaggerating, eight to 10 hours a day. So when we would joke, we had to make jokes otherwise we weren't going to survive. We would look at each other and say, we got a lemon. Can we turn him? We would joke because no one would talk about it. So we barely left our house. And that made it even worse. And that was not even the ideal I had in my mind. I remember being pregnant and thinking we could go on a trip when he's just a couple months old, and I didn't think babies cried in the car. That was not even a concept that was in my head.

(25:52): And so these were the things where this big gap between expectation and reality where I thought we were going to get up and go, our lives were going to remain unchanged for the most part. But with the baby in tow, and you see it on social media, people still do it. They're like, let's vlog for the day. Well, my vlogging would've been traumatic for everybody with a screaming baby in the background. So I was that big gap. It leaves so much room when there's this gap between expectation and reality, it leaves so much room for disappointment. It leaves so much room for shame, for feelings of inadequacy. We think we internalize that. We think I must be doing something wrong if it's not so easy for me. And truthfully, I sit with people day in and day out and they all tell me, this is so much harder than I thought it was going to be. It's just so much more challenging. It doesn't take away from yes, we're grateful. Yes, it's a beautiful experience. Yes, I wouldn't take it back, but that does not negate the fact that this is so hard.

Dr. Nicole (26:49): Now, I think these two kind of go together, but they're also very important is a loss of control over your life. And then your identity either lost or changed or however you want to put it. What role do you feel like that plays that you see with your clients in expressing anger or rage?

Dr. Ream (27:09): A loss of control is such a big one, and I find there's this profile, I would say if I see a profile of a mom or a parent that's coming in, it's a little more challenging and I'm going to share. It's also me, so it's fine. But there's this type a perfectionistic. I like predictability in my life. I'm efficient. I would maybe you describe yourself as like I'm high achieving, I like to get things done. I like things a certain way. And then when parenthood comes steamrolling through and everything is unpredictable, nothing can be planned and things are just unraveling in a way that you can't really know. It is. It causes such intense anxiety and irritability that that's what I do see in therapy and that's what I saw in myself. I was the kind of person that I live by a checklist. I live and die by the checklist. I want to know all the things I'm going to get done that day, how it's going to happen. And then you bring this little human in the world and they are like, I don't care. Thanks.

(28:15): We're actually not doing that today. I forgot to tell you. And you learn to be adaptable. But in the process of learning how to be adaptable, it's anxiety provoking. It creates irritability and frustration because you are not living according to the values that you set for yourself. You are not living according to the set of ideals that you have for yourself. And that's hard. And you feel like you lose yourself in the process like this loss of identity. Because if I was tying my identity to productivity or to achievement, or maybe it's even being social, but now I'm not able to do those things because I'm not getting to hang out with the people that I know and love because my circumstances, there's this loss of identity that way. And I remember going from, I was 37 weeks pregnant and I was talking to our manager at the clinic I was working at.

(29:08): We're planning for the future. I'm like, I want to lead these many groups. I want to change this. I want to do that. Once I come back from this maternity leave, this is what we're going to do. Nothing could stop me. I love my job. And then I have this little baby and I thought, do I have to go back? It was like, do I have to go back right now? Can I take a year off? Can you give me some more time? And my priorities shifted, but then with that shift, it was like I lost my identity because to myself, I was this career woman and I didn't know who I was. So there was this piece where it's like we're muddling through it all and we're trying to figure out who we are anymore. Sure. I'm not really communicating with the people I used to communicate with. I'm not doing a whole lot of things that make me feel like me. And that's frustrating and that's anger inducing, but we don't know. We don't have the words for it. When we're walking through it, we're feeling it. Yeah.

Dr. Nicole (30:01): Yeah, definitely. Definitely. So if someone is concerned and they're like, Hey, this is not me. Why am I so angry? What are two or three steps that they can take to address it?

Dr. Ream (30:14): Great question. I think one, identifying that first thing of identifying and recognizing this does not feel like me. When you start to say that and you feel that, pay attention to that voice. That was the very first thing. I actually remember sitting on the couch. I looked at my husband and this was before, I didn't even have a clue what was even going on with me. And I said to him, I don't feel like myself. And he was kind of probably nodding his head, yeah, you don't seem like

(30:41): Yourself. You've been a little different. I didn't want to say nothing, but

(30:47): No,

(30:48): But since we're talking about it,

(30:51): You said it not me. I remember verbalizing that. And I think the first part of sharing it with somebody that you love and trust, that is not going to reduce your feelings or invalidate you or make you feel like there's something wrong with you. If you have somebody in your life that you can trust, I would definitely encourage you to share. The other thing that you can do on your own is to pay attention to what I talk about. What I often talk about when I'm teaching on this topic are our nests, and it's these buckets of needs and our need for nourishment, our nutrition, our need for exercise, our need for support, time for ourself, and then sleep. These are these primary nests or needs buckets where if we're paying attention to those things, are they being met? And how can I move the needle to at least where I can work towards?

(31:45): I don't expect perfection, but if I'm not getting any of these needs met, how can I focus on just filling a few of those in just progressing through that, okay, I'm going to focus on feeding myself well. I'm going to focus on moving my body in a way that feels good. I'm going to call that friend. Just focusing on those things. And truthfully, because I'm a psychologist and I'm a proponent of therapy, I always encourage people to get connected with resources. Partum support international is an incredible resource with a robust directory of providers and talking to your provider, if you have an OB that you love and trust, I do personally, I would've went and told her everything. Talking to your provider, if it's your pediatrician, your lactation consultant, because if you don't feel comfortable and you don't know how to navigate this, sometimes really leaning on those professionals that you trust to say, I need help. I don't know where to turn. But getting connected with a therapist can change your life. It really can't. Truthfully, and sometimes medication is needed. I'm not saying that it's a necessity for everybody, but it can really help. And I want people to know that it's an option. Right,

Dr. Nicole (32:53): Right. I love that. I think also sometimes a therapist can help you. They see a view of your life that you aren't necessarily seeing or that even the people around you can't necessarily see. Sometimes you need an outsider perspective who's unbiased. That can just help you think through those buckets and say, Hey, well, are you getting sleep? And you don't even realize, well, actually maybe I'm not sleeping at all. So yes, I need to ask for help. So it can just be a really helpful strategy to help you get into a better place.

Dr. Ream (33:29): Of course. No, I totally agree. I mean, I sat with countless people that will even say to me, I've never told anybody this. To me as a therapist, I'm always like, wow, this is such an honor. Okay, I'm here. I'm all ears. Share it with me. I can hold space for this. But they tell you stuff and you're like, you get to work with them to connect the dots that they haven't connected or just listening and not sometimes offering the solution that your partner is going to offer, that's going to make you very aggravated. It is an incredible resource, and I think it's really cathartic and it's very helpful to have somebody who is, like you said, unbiased to sit with you and not judge you and really help you navigate that. Yeah,

Dr. Nicole (34:11): Definitely. Definitely. And we didn't talk about it, but what role does breastfeeding potentially play in this?

Dr. Ream (34:19): So I've done this twice and I actually recently weaned. So I can tell you this from personal experience, and I've done this twice and I've experienced this twice, but there is something, there is post weaning depression that can occur. This fluctuation in your hormone when you start to wean will increase these feelings of irritability and agitation, anxiety, depression. So I always tell people, obviously if you can, and it's not always possible to slowly wean. And I did. I'm like the person that's dropping one feet a week, and I was so agitated, I was so irritable. It was like, oh, I can't even be around people. I almost want to be living somewhere different because everything that came out of my mouth was snappy.

(35:04): I don't want to be around me. So I would say be gentle with yourself. It should not last. I would say a few weeks a month, if you're noticing these feelings are persisting, I would talk to your provider, but this is something that does occur. I've experienced it, my clients have experienced it, and you are going to feel like that anxiety. Like I said, sometimes this dysthymia and irritability where no joke said to my husband a few weeks ago, the sound of your breathing is frustrating me. It's irritating me. And he said, I'm going to give you a pass. I'm going to give you

Dr. Nicole (35:41): A pass. It's like, I can't stop breathing. Sure.

Dr. Ream (35:47): But I mean the level of what I was feeling, it was just like the simplest things were just frustrating me. And I'm like, this is not me. I am usually a chipper person. So it's be patient with yourself. You can even journal about it. I think that's really helpful, especially if you have more than one child or if you want to just journal the experience so you can reflect back on it and see what it was like. Talk to somebody that you love and trust, but if it persists and it's not getting better, definitely get connected with some resources.

Dr. Nicole (36:16): Okay, okay. For sure. So as we wrap up, what would you say is the most frustrating part of your work?

Dr. Ream (36:21): It's not going to be what anybody expects. It's the paperwork. Documentation. Yes. I never had to document ever again. I would see far more people and have way more fun, but that is the most frustrating part.

Dr. Nicole (36:38): Yeah, that's part of why I got out of the office. I could never keep up with charts. I was bringing charts home and all that kind of stuff. So I totally get that. So then on the flip side, what's the most rewarding part of your work?

Dr. Ream (36:48): I love to see the transformation. So I've worked in all different settings from residential treatment where you kind of see that transformation happen far more quickly to meeting with people for one year and just watch them navigate life and get out of the most challenging situations that when they initially came in into see me, felt very hopeless about, it's like you are almost like this distant person that's cheering them on. You're not really intimately a part of their life. I'm not walking out with them and going to the games that they're talking about with their kids and doing all the things. But it's just a great feeling when you see people making that movement and you feel so proud of them sometimes. I'm like, you're so cool. I'd hang out with you if I

Dr. Nicole (37:31): Wasn't your therapist. Awesome. I love it. So then what is your favorite piece of advice that you'd give to an expectant mom?

Dr. Ream (37:42): This piece of advice has not changed in years and seven years that I've been working with parents. My advice is that you can change your mind. And I know that seems like such a simple thing that maybe does not make a whole lot of sense to some, but I needed to hear this when I was first postpartum and I was so rigid and stuck on I am going to be the mom who does these things. And if I could go back, I would tell her, you can change your mind. It's okay, and it's going to be all right if you do change your mind. This is not earth shattering and this expectation of not just focusing on the now but the future in five years, is this decision going to be this big? Is it going to be this heavy as I feel like it is right now? And I wish I would've had that voice that could have told me that back then when I thought every decision I was making was going to change the trajectory of my life and my son's life at the time.

Dr. Nicole (38:37): Right. Yeah. Yeah, that's great advice. So where can people find you and connect with what resources you have? Tell us about all the things you have to offer.

Dr. Ream (38:45): All of the things. So I am psyched mommy on most social media platforms, and my website is also psyched mommy.com. And also I do offer a course called All the Rage, and I host that with Erica Jasa of Mom. Well, and we go through the entire experience of rage and anger, and we break it up a lesson to lesson on understanding anger, the vulnerabilities, where we received these messages from, and how to navigate them with really practical tools. So you could find that on my website. It's like mommy.com as well as mom freely.com, and we offer a free masterclass where we teach parents how to repair after they have lost their cool, because it's an inevitable experience that, I mean, I'm a psychologist and I lose my goal and my son's like, mommy, you're kind. You're not having a good day. And I'm like, you're right. So we walk you through the steps on how to repair so that we can really repair those ruptures that we have with our family.

Dr. Nicole (39:47): Gotcha. Awesome. Well, thank you so much Dr. Ream, for agreeing to come onto the podcast. This is such useful information, so appreciate

Dr. Ream (39:54): It. Thank you.

Dr. Nicole (40:01): Wasn't that a great episode? Such an important topic. And Dr. Ream is so well-educated well, well-versed and great at sharing information with us. I'm so grateful that she came on today. Now, after every episode when I have a guest on, I do something called Dr. Nicole's notes where I talk about my takeaways from the conversation. Here are my Dr. Nicole's notes from my conversation with Dr. Ream. Number one, it is totally normal not to all aspects of motherhood or pregnancy. You may not enjoy pregnancy, you may not enjoy everything about motherhood. Social media sometimes makes it appear like everything is flowers and rainbows, and that is just not the case. There can be some difficult moments, and if you don't like everything about pregnancy, I personally didn't like much of anything about pregnancy except feeling the kicks. That doesn't make you a bad mother. It doesn't make you a bad person.

(41:00): There is nothing wrong with you. As a matter of fact, what it makes you is completely 1000% normal. Okay? Number two, unfortunately, the reality of life is that life will continually have challenges. And that can be challenges during pregnancy. That can be challenges during labor, challenges during motherhood, challenges with relationships, challenges at work. All of those things are just a part of life. Now, of course, that doesn't mean there's not a whole lot of joy in life as well, and we work to cultivate that joy and happiness. But along with that hand in hand is going to be challenges. It's just the reality of being a human being in this world, in this universe. Now, what is important is how we deal with those challenges, because they're not going to go away. For me personally, many times I've been like, oh my God, why is this happening?

(42:06): Why does this have to be? Why is this the case? And they're not going to be answers to some of those challenges or most of those challenges. So instead of answering or thinking or asking rather why, just think about how you deal with challenges. And I've learned that when you get better and better and practice at dealing with challenges, then it gets easier to deal with them. And it doesn't mean there's not going to be painful, but that pain is not going to last as long and you can snap back quicker. So life motherhood is going to have challenges. How you deal with it matters. It gets easier with practice. And then the last couple of things I want to say is that shame is such a strong and difficult emotion, and it can easily get evoked in the setting of pregnancy, birth, and of motherhood because people can be judgy a f.

(43:04): Also, social media and society standards can put a lot of unfair pressure on you as a pregnant woman or person as a mother, and not living up to those unrealistic expectations can create feelings of shame. Or as Dr. Ream mentioned, sometimes you do things and you lose your cool or things like that. That can create things of shame. I want you to please give yourself some grace. Not one of us in this life is perfect, not a one of us. We all make mistakes, okay? Just continue to do the best you can. Brush yourself off, pick yourself up. That is all that we can do. Try not to let shame consume you. All right? Please give yourself some grace. All right? So there you have it. Please be sure to subscribe to the podcast wherever you're listening to me right now, and leave me a review on Apple Podcast. I do shout outs from those reviews from time to time. It also helps the show to grow. And do come join me in my next live at Free birth plan class. Make a birth plan the right way. You can sign up for that class at drnicolerankins.com/birth plan. So that is it for this episode to come on back next week and remember that you deserve a beautiful pregnancy and birth.