My Go-To Cognitive Behavioral Therapy Coping Tools

One of the hardest things to hear as a parent who is struggling with depression or anxiety is, “Oh yeah, I had postpartum depression and it just went away.” That’s great, but tell me HOW. How did it go away? Maybe her hormones evened out, or financial stressors resolved, or the baby started sleeping through the night, but when you’re deep in in, you need some tools you can pull out of your toolbox to get you through the day. Let’s talk about some specific Cognitive Behavioral Therapy coping tools for dealing with postpartum depression and anxiety, or you know, the stress of plain old life:

All of these strategies require you to stop, breathe, and think, which helps calm you out of “fight or flight,” aka panic, mode. You might already use some of these techniques! I don’t know about you, but sometimes, I need to be reminded of what I already know is true. The goal is not to stress about mastering all of them, but to pick one and commit to giving it a shot today, or this week. So here we go:

  • Generate Alternatives: How often do we immediately jump to the worst-case scenario in our minds? Instead of believing the worst-case scenario outright, you play with and question it. For example, “What’s the worst-case scenario? (Don’t stay here.) Ok, now what’s the best-case scenario? What is the most plausible scenario? What are two other possible scenarios?” You come to realize as you ask yourself about alternative scenarios that your fear-based predictions are not guaranteed to come true. Sometimes our friends do this for us, i.e. “Oh that’s not going to happen. Don’t worry about it!” But when we’re more isolated as moms or dads at home with the baby, we don’t always have those sane voices as readily available and we need to learn to start doing this for ourselves. You might have found yourself, on a good day, doing this naturally!

 

  • Empowering or “Anti- Catastrophic” Thinking: Deflate the fear fueling those worst-case scenarios by creating a strategy. Ask yourself, “What’s the worst-case scenario? How likely is that to actually happen? If it did happen, what would I do about it? How would I handle it and get through it?” You come to a place of empowerment as you ask yourself these questions. You are capable of coming up with solutions. You are a fierce mama bear. It’s in your DNA. What’s an example of a time you have done this for a friend or another mama to help her move from a place of helpless worry to empowered action?

 

  • Talk to yourself as a friend: This is one of my favorites because it’s so simple and effective. Challenge an anxious or negative thought by pretending you are talking to a friend instead, and you’ll find you might actually come across as more objective, compassionate, and kind. If you wouldn’t talk to a friend the way you are talking to yourself, or if you wouldn’t accept that from your mother-in-law, then don’t accept it in your own mind. 

 

  • Reframe Worry as Evolutionarily Adaptive: Did you know that anxiety is actually your brain being hyper-vigilant about doing your best for your baby? Dr. Judith Lothian wrote in the Journal of Perinatal Education that “High levels of estrogen and progesterone and their complex interaction with each other and with less well known hormones contribute to the pregnant woman’s increased sensitivity and emotionality, the tendency to be fearful, and heightened concern for her own safety and that of her baby. These changes propel the pregnant woman to seek safe passage for herself and her baby, foster her attachment to her growing baby, and, ultimately, guide her through the important process of giving more and more of herself during first her pregnancy, then labor and birth, then breastfeeding and care of her baby (Buckley, in press; Mercer, 1995; Rubin, 1984).”[1] The point is that intrusive thoughts of harm coming to your baby are not pleasant or something you want to dwell on, but they are nature’s way of helping you be the protective mother hen you need to be. Think about it, we as mothers care for the most helpless, least developed mammals on the planet, and so it makes sense that a switch would be flipped in our brains to turn on those annoying and sometimes horrifying thoughts to warn us to avoid sharp objects, take a wide berth around corners and edges, watch your step on slippery surfaces, dodge the snarling dog in case it lunges at you and your baby. When we have intrusive, worrisome thoughts, instead of being terrified or ashamed of them, we reframe them as evolutionarily adaptive and look for it to be so. Think of it like a good thing gone overboard, and tell someone who will understand in order to take away the power the thought is holding over you. Shame causes us to be secretive sometimes. I will say it again: these thoughts are not pleasant or anything we need to dwell on, but they are intended to be helpful. Brush away the worry that you are going crazy like an annoying fly buzzing about your head. Thoughts come and go. Only when we focus our attention on them do we give them an unnecessary amount of power. Then, stop ruminating. Tell your brain, “I got the memo, I will avoid the sharp corner. No need to remind me again.” Print out a sign that says STOP or REDIRECT and put it on your fridge if you need a visual reminder. Or put a coin in your pocket to remind yourself that sometimes our weaknesses are the flip side of the coin of our strengths. I’m sure many of you can relate to this!

 

  • Image Substitution: When a negative image of a worst-case scenario, or an intrusive thought of harm coming to your baby, pops into your head, you literally envision the opposite. Are you worried about waking up in the night to a screaming, colicky baby? Then you envision yourself cool, calm and collected as you breastfeed her and set her down gently her in her crib where she is now sleeping peacefully. Are you seeing her head come into contact with the corner of the coffee table? Then you envision yourself being aware of the danger and taking a wide berth around the table and placing her safely in her stroller to go outside for a walk. Those thoughts might pop into your head, but you don’t have to give them power by focusing your attention on them. Shift your attention to something you want to happen. Do you think you could try that?

 

  • Progressive Muscle Relaxation: Did any of you hear the phrase growing up, “If you don’t have anything nice to say, don’t say anything at all?” I don’t like that phrase as a counselor, but sometimes when you don’t have good to think, there’s no need to think anything at all. Ground yourself in your physicality, in your body. We are more than our thoughts; we are body, soul, and psyche. If you feel like you can’t turn off the negative or anxious thoughts in your head, or if it’s subtler than that and you just can’t shake those down, blah, moving-in-slow-motion feelings, try this exercise called progressive muscle relaxation. It’s like a guided meditation you can do for yourself, in which you simply tell each of your body parts to clench and let go, and you physically do it. The beauty of it is you can do it sitting down or standing up, whether you’re changing a diaper, washing bottles, driving, showering, or laying in bed. Let’s try it now. Close your eyes if you want to. Starting at your feet, say to yourself, either in your mind or out loud, “Feet, tense up and release. Calves, tense up and release. Thighs, tense up and release. Hips, tense up and release. Stomach, tense up and release. Chest, tense up and release. Hands, tense up and release. Arms, tense up and release. Shoulders, tense up and release. Neck, tense up and release. Jaw, tense up and release. Head, tense up and release. Eyes, close and open up.” And while you’re at it, your OB would appreciate it if you would throw in a few Kegel exercises! How do you feel now? 🙂

My Stop, Breath and Think meditation for the day: Relax, Ground & Clear. Will you join me? #sbt

[1] (Lothian, 2008)

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