Setting Boundaries with Confidence: The Nuance of Personal Boundaries

Setting and maintaining personal boundaries is one of the most important skills we can cultivate for our mental health and well-being. But during the holidays—it can feel uniquely challenging. Family gatherings, cultural expectations, and the pressure to “keep the peace” often clash with our need to prioritize our own emotional safety.

For many women, navigating boundaries during holidays involves balancing a desire for connection, the urge to please others, and a need for self-protection. You may feel pulled between honoring family traditions and respecting your own limits, and that’s okay. The good news? Boundaries can help you show up authentically while also taking care of yourself.

Exploring the nuances of boundary setting can help to find strategies that fit your objectives and values. Understanding the difference between rigid, porous, and healthy boundaries, along with practical tips (and scripts!) for setting boundaries, can help with managing interpersonal stress during the holidays.

What Are Personal Boundaries?

Personal boundaries are the limits we set to protect our emotional, physical, and mental well-being. They define what we are and are not willing to tolerate in our relationships, conversations, and environments. Boundaries are not about controlling others—they’re about protecting yourself and creating a sense of safety and respect.

Healthy boundaries are a form of self-care, allowing us to maintain relationships without sacrificing our needs or values. However, boundaries can vary widely in how they are expressed.

Rigid, Porous, and Healthy Boundaries

Rigid Boundaries

Rigid boundaries involve being overly closed off or inflexible. They may look like avoiding all vulnerability, refusing to share personal information, or keeping people at a distance to avoid emotional discomfort. For example, someone with rigid boundaries might refuse to engage in any family traditions because they fear conflict.

• Example: Declining to attend a family gathering but not offering any explanation or alternative way to connect.

Porous Boundaries

Porous boundaries involve being overly open, accommodating, or enmeshed with others. They may look like prioritizing other people’s needs over your own, saying “yes” when you mean “no,” or oversharing personal information. For example, someone with porous boundaries might agree to host holiday dinner despite feeling completely overwhelmed.

• Example: Letting someone’s critical comments about your lifestyle slide because you don’t want to “make things awkward.”

Healthy Boundaries

Healthy boundaries strike a balance between protecting your needs and fostering meaningful connections. They involve being clear, respectful, and assertive about your limits while remaining open to mutual understanding. Healthy boundaries are grounded in self-awareness and self-compassion.

• Example: Politely declining a conversation about politics or religion while staying engaged in the aspects of the gathering that feel enjoyable.

How to Set Boundaries During the Holidays

Holidays can be full of love, but it can also bring challenges—unsolicited advice, invasive questions, or the pressure to take on more than you can handle. Setting boundaries is an essential tool to navigate these moments with grace and self-respect.

Here’s how to do it:

1. Be Clear and Direct

The most effective boundaries are communicated clearly and without ambiguity. A direct statement lets others know what you need without leaving room for misunderstanding.

• Example: “I love spending time with everyone, but I won’t be discussing my personal life today. Let’s talk about something else.”

2. Decide What You’re Comfortable With

Boundaries are deeply personal and depend on what feels right for you. Take some time before the holidays to reflect on your limits. Are you okay with attending the gathering but need to skip certain conversations? Are you willing to help in the kitchen but don’t want to host?

• Example: If you’re uncomfortable with political debates, you might say, “I’m here to enjoy the holiday, so I’m going to step out if the conversation turns political.”

3. Use “I” Statements

When setting boundaries, focus on what you are willing to do rather than telling others what they can or cannot do. This keeps the focus on your needs rather than controlling someone else’s behavior.

• Example: Instead of saying, “You can’t talk to me about my career,” you might say, “I’m not comfortable discussing my job today, so I’ll change the subject if it comes up.”

4. Give Yourself Permission to Say No

Saying “no” is a complete sentence, and it doesn’t make you a bad person. Declining an invitation, a task, or a conversation is your right—especially when it protects your mental health.

• Example: “I appreciate the invitation to stay late, but I’ll need to leave by 8 p.m.”

Boundaries in Action

Boundaries during the holidays can take many forms. Here are some examples of how boundaries might look in practice:

Direct Statements

• “I’m happy to help with dinner, but I’ll need some time to myself afterward to recharge.”

• “I’d prefer not to talk about my relationship status. Let’s catch up on something else instead.”

Not Talking About Certain Topics

• Politely redirect the conversation if someone brings up weight, diets, or appearance:

• “I’m focusing on enjoying the food and company today, so let’s skip the diet talk!”

Not Doing Certain Activities

• If you’re asked to take on more than you can handle, say:

• “I can bring a dish, but I won’t be able to help with setup this year. Thanks for understanding!”

Not Attending an Event

• If you decide not to attend a gathering, you can communicate with kindness:

• “Thank you for inviting me. I’ve decided to take this holiday to rest, but I hope we can connect soon.”

Scripts for Setting Boundaries

Sometimes, it’s hard to find the right words in the moment. Here are some scripts you can adapt for different scenarios:

• For Unsolicited Advice:

• “Thank you for your input, but I’ve got this handled in my own way.”

• For Invasive Questions:

• “I’m not comfortable discussing that right now. How have you been?”

• For Food or Body Comments:

• “I’d rather not talk about my body or eating habits. Let’s focus on enjoying the meal!”

• For Political or Religious Debates:

• “I value our relationship too much to let a disagreement ruin the day. Let’s keep it light.”

• For Feeling Overwhelmed:

• “I’m going to step outside for a few minutes to regroup. I’ll be back shortly.”

Boundaries Are About You, Not Controlling Others

One of the most important things to remember about boundaries is that they’re about your actions and limits, not about controlling someone else’s behavior. Setting a boundary doesn’t guarantee that others will respect it, but it does give you the power to protect your well-being.

For example:

• If someone continues to bring up a topic you’ve said is off-limits, you can remove yourself from the conversation rather than trying to make them stop.

• If someone pressures you to eat or drink something you don’t want, you can politely decline without needing their approval.

Boundaries are about taking responsibility for your own needs while respecting that others may have different perspectives or behaviors.

Why Boundaries Matter

Boundaries are an act of self-love. They help you show up authentically, maintain your mental health, and foster relationships that are built on mutual respect. For women, who are often socialized to prioritize others’ needs over their own, setting boundaries can feel uncomfortable at first—but it’s a powerful step toward reclaiming your time, energy, and peace of mind.

Honoring Boundaries and Creating Connection

Holidays don't have to be perfect to be meaningful. By setting and honoring your boundaries, you can create space for connection, joy, and self-compassion—on your terms.

If navigating boundaries feels difficult, that’s okay. Like any skill, it takes practice. The key is to approach it with kindness toward yourself and others. Remember, your needs are valid, and it’s okay to prioritize your mental health. You deserve a holiday season filled with care—for yourself and the relationships that matter most.

What You Need to Know About Health Insurance and Deductibles for Therapy Services in the New Year

Navigating health insurance can feel like trying to read an ancient map with missing pieces—confusing, frustrating, and overwhelming. When it comes to mental health services like therapy, understanding how your insurance works, particularly regarding deductibles, is essential for ensuring you can continue receiving the care you need.

At Wild Hope Therapy, we want to empower you with the knowledge to make informed decisions about your mental health coverage. In this guide, we’ll explain how health insurance is used to pay for therapy, what deductibles are, how they reset at the beginning of the year, and what steps you can take to prepare for any changes. We know this process can be complicated, but with the right information and support, it’s manageable—and worth it.

Using Health Insurance for Mental Health Services

Health insurance can make mental health services like therapy more affordable by covering a portion of the costs. When you use insurance, the process usually involves these key terms:

• Premiums: The monthly amount you pay to maintain your health insurance.

• Copay: A set amount you pay for each session, such as $25 or $40, depending on your plan.

• Deductible: The amount you must pay out of pocket for covered services before your insurance starts covering more of the cost.

• Coinsurance: A percentage of the cost you’re responsible for after your deductible has been met.

For example, if you see a therapist who charges $150 per session, and your plan has a $25 copay for mental health services, you would pay $25, and your insurance would pay the remaining $125 (or the fee the insurance company has contracted with your provider, often less than their full fee.) The confusing part is that this does not kick in until after you meet your deductible (if applicable). That means that if your deductible hasn’t been met, you may be responsible for the full session cost until you’ve reached your deductible amount.

What Is a Deductible?

A deductible is the amount you must pay out of pocket for covered health services before your insurance begins to pay its share. Deductibles can vary widely depending on your insurance plan—some are as low as $500, while others can be $2,000 or more.

Here’s an example of how a typical deductible might work:

• Your insurance plan has a $1,000 deductible.

• You attend therapy sessions at Wild Hope Therapy, for which your insurance provider agrees to pay a contracted rate (usually different than your clinician’s listed rate.)

• Until you meet your deductible, you will pay the full contracted rate per session out of pocket.

• Once you’ve paid $1,000 for covered health services (including therapy), your insurance kicks in. After that, you might only need to pay a copay (e.g., $25 per session) or a coinsurance percentage (e.g., 20% of the session cost).

For many insurance plans, deductibles reset at the beginning of the year, meaning you start from zero on January 1st.

Why Deductibles Reset in the New Year

Deductibles typically run on a calendar year basis, starting on January 1st and ending on December 31st. If you’ve met your deductible during the previous year, you may have become accustomed to paying lower costs for therapy sessions (e.g., just your copay). But once the new year begins, you’ll need to meet your deductible again before those lower costs resume.

This shift can catch people off guard, especially if they’re not aware of how deductibles work. Suddenly paying more for sessions that were previously covered can be frustrating, but understanding this process in advance can help you plan and budget for the transition.

Steps to Ensure You’re Prepared for Changes

If you’re unsure how your insurance will affect your therapy costs after January 1st, here’s what you can do to prepare:

1. Check Your Plan Details

Log into your insurance portal or call your insurance provider to review your plan’s deductible, copay, and coinsurance amounts. Make note of whether your deductible resets on January 1st and how much you’ve already paid toward it this year. If it resets at a different time of year, set a reminder in your calendar to redo this process then!

2. Estimate Costs for the New Year

If you have not met your deductible by December 31st, calculate how much you’ll likely need to pay for therapy sessions at the start of the new year. For example, if your deductible is $1,000, and your therapy sessions cost $150, you’ll pay for about seven sessions out of pocket before your deductible is met.

3. Clarify Your Copay or Coinsurance

Once your deductible is met, find out what your financial responsibility will be for each session. This could be a set copay (e.g., $25) or a percentage of the session cost (e.g., 20%).

4. Contact Your Therapy Practice’s Billing Specialist

At Wild Hope Therapy, we understand how challenging it can be to navigate insurance. That’s why we have a dedicated billing specialist, Mindy Hubert, who can help answer your questions. While we can’t provide exact quotes, Mindy is here to provide guidance and support to help you better understand your coverage. You can reach her at billing@wildhopetherapy.com.

5. Plan Ahead Financially

If your deductible resets and you’ll need to pay more for therapy at the start of the year, consider adjusting your budget to account for the temporary increase. This can help you avoid interruptions in care.

Tools for Managing Insurance Frustration

Let’s face it: dealing with insurance can be a headache. But there are ways to reduce the stress and confusion:

1. Keep Detailed Records

Maintain a file (digital or physical) with important insurance documents, such as your explanation of benefits (EOBs), invoices from therapy sessions, and notes from conversations with your insurance provider. Having everything in one place makes it easier to track your progress toward your deductible and resolve any billing questions.

2. Use Your Insurance Portal

Most insurance providers have online portals where you can access plan details, view claims, and track your deductible status. Familiarize yourself with this tool to stay informed about your coverage.

3. Advocate for Yourself

If something doesn’t make sense, don’t hesitate to call your insurance provider for clarification. While it can be frustrating to wait on hold, getting clear answers is worth the effort. You are entitled to understand your plan and how it works.

4. Lean on Your Therapy Practice for Support

At Wild Hope Therapy, we’re here to help you navigate this process. While we can’t resolve issues directly with your insurance provider, we can provide billing statements, help you understand your financial responsibility, and guide you in asking the right questions.

5. Be Patient with Yourself

It’s okay to feel overwhelmed or frustrated by the complexity of health insurance. Remember that you’re doing the best you can, and each step you take to understand your plan is a step toward ensuring consistent access to care.

Therapy Is Worth It—Even When Insurance Is Complicated

We know that navigating insurance isn’t always easy, and it can be especially frustrating when deductibles reset or costs change unexpectedly. But your mental health is worth the effort. Therapy is an investment in yourself—a way to prioritize your well-being, find support, and work toward your goals.

At Wild Hope Therapy, we’re committed to helping you access the care you need. Whether you’re navigating insurance questions, adjusting to new deductible requirements, or simply trying to understand your plan better, know that we’re here for you. Our billing specialist, Mindy Hubert, is always available at billing@wildhopetherapy.com to help guide you through the process.

Preparation, support and the right resources

Yes, insurance can be confusing, and deductibles resetting at the start of the year might feel like one more hurdle. But with preparation, support, and the right resources, you can navigate these challenges and continue your journey toward healing.

Remember: You are not alone in this process. Whether it’s understanding your coverage, budgeting for therapy, or working through mental health challenges, you have a team behind you. And with each step, you’re taking control of your mental health and prioritizing what matters most—your well-being.

Coping With Holiday Party Anxiety When You Have Experienced Disordered Eating

The holiday season can be a joyful time of connection and celebration, but for those of us who have experienced disordered eating, it can also bring a unique set of challenges. Food-centric gatherings, comments about bodies, and the pressure to appear “merry” can stir up feelings of anxiety, shame, or overwhelm. If you’re feeling apprehensive about holiday parties, know that you are not alone—and that it’s possible to enjoy the season while prioritizing your mental health and well-being.

At Wild Hope Therapy, we understand the complexities of navigating the holidays when food and body image concerns are part of your story. This blog offers compassionate insights, practical tools, and encouragement to help you move through the season with confidence and self-care.

The Intersection of Holidays, Food, and Anxiety

The holidays often center around food—grand meals, cocktail hours, cookie exchanges—and this focus can feel especially daunting if you’ve struggled with disordered eating. Whether you’re in recovery or still finding your footing, the abundance of food combined with social pressures can trigger old thought patterns or anxieties.

For women, societal messages about our worth being tied to appearance or self-control can add another layer of stress. Comments like, “I shouldn’t eat that, but I will,” or, “Look at how much weight I gained over the holidays,” can feel deeply unsettling, especially when you’re working to heal your relationship with food and your body.

But here’s the truth: you are more than your body, and your worth is not determined by what’s on your plate or how you look in holiday photos.

Planning for the Holidays: What to Expect

Holiday parties often come with certain dynamics that can feel overwhelming. Being prepared can help you navigate these situations with greater ease:

1. Food-Centric Gatherings

Many holiday events revolve around food. While this can be a source of joy for some, it may feel stressful if you’re managing your relationship with eating.

2. Diet Talk and Body Comments

It’s not uncommon for people to make offhand remarks about food, diets, or body changes during holiday gatherings. These comments, even when not directed at you, can be triggering.

3. Busy Schedules

Back-to-back events, travel, and socializing can leave you feeling drained or out of routine, which may amplify stress.

4. Emotional Triggers

The holidays can bring up a mix of emotions—joy, nostalgia, grief, or even loneliness—which can sometimes complicate your feelings around food and body image.

Coping with Food-Related Anxiety at Holiday Parties

When holiday parties feel overwhelming, small steps can make a big difference. Here are some ways to navigate food-focused gatherings with care and intention:

1. Set Boundaries Around Food and Conversation

It’s okay to advocate for yourself. If someone comments on what you’re eating, try redirecting the conversation. You could say:

• “I’m focusing on how I feel, not the specifics of what’s on my plate.”

• “Let’s talk about something more fun—how’s your holiday season going?”

If you feel pressured to eat or not eat certain foods, remember that you have the right to make choices that feel best for you, no explanations needed.

2. Bring Food You Feel Comfortable With

If the idea of eating unfamiliar food at a party feels daunting, consider bringing a dish or snack that you know you’ll enjoy. This can help you feel more grounded and ensure there’s something on the table that aligns with your needs.

3. Avoid “Food Rules” Conversations

When conversations turn to dieting or guilt about food, it’s okay to step away. Take a moment to breathe, engage in another conversation, or excuse yourself for a quick break. Protecting your mental space is a form of self-care.

Managing Social Anxiety and Overwhelm

Holiday parties aren’t just about food—they’re also social events, which can feel draining or anxiety-inducing. Here’s how to navigate the social aspects with ease:

1. Plan Your Arrival and Exit

Give yourself permission to set time limits for events. If a party feels overwhelming, let yourself leave early or plan an escape route in advance. You don’t need to stay longer than feels comfortable.

2. Focus on Connection, Not Perfection

Shift your focus from trying to “perform” or fit a specific holiday ideal to simply connecting with others. Find someone you enjoy talking to and engage in meaningful conversation—it’s okay if you’re not mingling with everyone in the room.

3. Bring a Grounding Object

Having something small to anchor you—like a bracelet, a meaningful trinket, or even a favorite lipstick—can remind you of your strength and resilience if anxiety starts to creep in.

Staying True to Your Values

For many women, the holidays come with expectations—what you should wear, how you should look, how much you should eat or drink. But your values, not societal pressures, should guide how you approach the season.

1. Reflect on What Matters Most to You

Ask yourself: What do I truly want from this holiday season? Maybe it’s creating joyful memories with loved ones, prioritizing rest, or focusing on gratitude. Write these intentions down and refer back to them when stress arises.

2. Define Your Own Traditions

Who says holiday traditions have to revolve around food or extravagant parties? Consider creating rituals that feel meaningful to you, like taking a winter walk, writing gratitude notes, or having a movie night with close friends.

3. Celebrate Your Progress

If you’ve worked to heal your relationship with food and your body, take time to honor that progress. The holidays can be a good opportunity to reflect on how far you’ve come and celebrate the ways you’re growing.

Building a Support System

Navigating the holidays is easier with people in your corner. Here’s how to build and lean on your support system:

1. Identify a “Go-To” Person

Having a trusted friend or family member who understands your journey can be invaluable. Let them know how they can support you—whether that’s redirecting conversations, standing by your side during meals, or checking in after events.

2. Communicate Your Needs

Don’t be afraid to set expectations with those closest to you. For example: “It would mean a lot if we could focus on enjoying the time together and avoid diet talk.”

3. Seek Professional Support

If the holidays feel particularly challenging, consider reaching out to a therapist. At Wild Hope Therapy, we specialize in helping women navigate the complexities of disordered eating, body image, and anxiety. You don’t have to face this season alone.

Tools for Managing Holiday Stress

When holiday anxiety feels overwhelming, grounding yourself can help. Here are a few tools to keep in mind:

1. Practice Mindful Breathing

Take a moment to pause and breathe deeply. Try inhaling for a count of four, holding for four, and exhaling for four. This simple exercise can calm your nervous system and bring you back to the present moment.

2. Keep a Journal Handy

Writing down your thoughts and feelings can help you process emotions and identify triggers. You can also use your journal to set intentions for events or reflect on moments of gratitude.

3. Create a “Safe Space” Ritual

If a party feels overwhelming, step outside or find a quiet corner to ground yourself. Engage in a quick ritual—like listening to a favorite song or focusing on your grounding object—to recenter.

Redefine What the Holidays Mean to You

The holidays can be complex, especially if you’re managing disordered eating or anxiety, but they don’t have to feel impossible. By planning ahead, setting boundaries, and staying true to your values, you can move through the season with greater ease and intention.

Remember, it’s okay to prioritize your mental health, to say no to situations that feel overwhelming, and to redefine what the holidays mean to you. Whether that means creating new traditions, leaning on your support system, or simply taking each day as it comes, you are deserving of a season that feels joyful and aligned with who you are.

You don’t have to navigate this journey alone. If you need support, Wild Hope Therapy is here to help. Together, we can work toward a holiday season that feels less about stress and more about connection, compassion, and care—for yourself and others.

Overwhelm and Extreme Consumerism: Finding Peace and Staying True to Your Values During the Holidays

The holidays are a time for joy, connection, and generosity—but for many women, they’re also a season filled with anxiety about shopping. Between the pressure to find the “perfect” gift, the endless sales emails flooding your inbox, and the societal push toward extreme consumerism, it’s easy to feel overwhelmed. Add in the complexities of receiving gifts—where expectations, gratitude, and sometimes guilt collide—and you might find yourself dreading what’s supposed to be the most wonderful time of the year.

The truth is, holiday consumerism can feel at odds with our deeper values. Many women value meaningful connection, sustainability, and authenticity, but these ideals can get lost in the frenzy of shopping, spending, and keeping up appearances. If this resonates with you, you’re not alone—and there’s a way to approach the season with intention and calm.

This blog will explore the anxiety that can come with both giving and receiving gifts, the impact of consumerism on our mental health, and practical strategies for managing holiday stress while staying true to your values.

The Anxiety of Gift Giving

For many women, gift giving isn’t just about the gift itself—it’s about the deeper meaning we attach to it. We want our gifts to be thoughtful, personal, and reflective of how much we care about the recipient. But when we’re faced with endless shopping lists, crowded stores, or the sheer number of options online, this desire for meaningful giving can morph into stress and self-doubt.

Common Sources of Gift-Giving Anxiety:

• Worrying About Getting It “Right”: What if they don’t like it? What if it’s not thoughtful enough? What if someone else gets them the same thing?

• Financial Strain: The pressure to keep up with family or friends who might have bigger budgets can feel overwhelming, especially if money is tight.

• Overcommitment: Trying to find the perfect gift for everyone can leave you spread too thin, physically and emotionally.

The Anxiety of Receiving Gifts

Receiving gifts can be just as anxiety-provoking as giving them, particularly for women who are conditioned to be “grateful” and “gracious” at all times. While gifts are often a sign of love and appreciation, they can sometimes come with complicated feelings.

Common Sources of Gift-Receiving Anxiety:

• Feeling Uncomfortable Being the Center of Attention: Opening gifts in front of others can feel awkward or expose insecurities about whether you’re showing “enough” gratitude.

• Guilt About the Cost: If someone spends more on you than you’re comfortable with, it can create feelings of guilt or an unspoken pressure to reciprocate.

• Unwanted Gifts: Receiving items you don’t need, want, or have space for can create tension, especially if you feel obligated to hold on to them.

Consumerism and Values

The holiday season is deeply tied to consumer culture, and this can create a disconnect between how we want to live and what we feel pressured to do. Advertisements and social media bombard us with messages that equate love with spending, urging us to buy more to prove our care. But for many women, this approach feels hollow, leaving us emotionally and financially drained.

If you’re feeling this tension, it’s worth taking a step back to reflect on your values:

• What truly matters to you during the holidays? Is it connection, kindness, or joy?

• Does extreme consumerism align with your values? Or does it distract from them?

• How can you give and receive gifts in a way that feels authentic to who you are?

By grounding yourself in what you care about most, you can begin to navigate the season with more clarity and less stress.

Staying True to Your Values: Thoughtful Giving and Receiving

Here are some ways to approach holiday gifting in a way that aligns with your values:

1. Choose Meaningful, Not Extravagant

Focus on gifts that reflect thoughtfulness rather than expense. A handwritten letter, a photo album, or a homemade treat can often mean more than a high-ticket item.

2. Have Honest Conversations About Budget

If you’re feeling stretched financially, it’s okay to set boundaries. Consider suggesting a Secret Santa exchange, setting spending limits, or gifting experiences rather than physical items.

3. Create a “Wish List” Culture

If you’re worried about receiving gifts you don’t need, encourage an open dialogue about what you and your loved ones truly want or need. This reduces guesswork for the giver and ensures the gift is appreciated.

Managing Anxiety Around Holiday Shopping

The hectic shopping season can be overwhelming. Crowded stores, long lines, and the endless scroll of online options can leave you feeling frazzled and stressed. If this sounds familiar, here are some strategies to help:

1. Set Limits on Time and Spending

Decide in advance how much time and money you’re willing to spend on holiday shopping. Setting clear limits can help you avoid overspending or exhausting yourself.

2. Shop Early or Online

Avoid the last-minute rush by planning ahead or shopping online at a relaxed pace. Many small businesses also offer curated gift guides to help narrow your options.

3. Take Breaks

Shopping fatigue is real, especially when it’s accompanied by decision fatigue. Give yourself permission to take breaks, step outside, or treat yourself to something calming during a long day of shopping.

Managing Anxiety Around Internet Shopping

Online shopping can feel easier than braving the mall, but it comes with its own set of challenges. The sheer number of options and constant sales can be overwhelming, leaving you scrolling for hours without making a decision. Here’s how to manage:

1. Start with a List

Before you open your laptop, write down exactly who you’re shopping for and what you’re looking for. A focused list can help you avoid falling down the rabbit hole of endless browsing.

2. Set a Timer

It’s easy to lose track of time while shopping online. Set a timer for 30 minutes to keep yourself focused and to prevent burnout.

3. Support Small or Local Businesses

Shopping with smaller businesses often provides a more curated, intentional experience, reducing the overwhelm of browsing massive online retailers. It also aligns with values of sustainability and community.

Managing Emotional and Financial Strain

If you’re feeling anxious about spending or navigating family expectations, here are some strategies to ease the pressure:

1. Practice Self-Compassion

Remind yourself that you don’t need to “buy love” through expensive or elaborate gifts. Your worth is not tied to what you spend or how perfectly you give or receive.

2. Create New Traditions

If traditional gift-giving feels too stressful, suggest alternatives. Host a potluck, organize a holiday movie night, or plan a group volunteer day. Shifting the focus from material goods to shared experiences can help ease anxiety.

3. Budget in Advance

If finances are tight, plan ahead by setting aside a small amount each month for holiday expenses. Having a dedicated fund can reduce stress and help you avoid overspending.

Connection, love, joy

The holidays don’t have to be about stress, anxiety, or extreme consumerism. By focusing on what matters most—connection, love, and joy—you can navigate the season with intention and peace.

Remember, the value of a gift isn’t in its price tag but in the thought and care behind it. Your presence, your kindness, and your genuine love are the most meaningful gifts you can give to the people who matter most.

If anxiety around giving and receiving gifts feels overwhelming, take a deep breath and ground yourself in your values. You’re not alone in feeling this way, and it’s okay to set boundaries and make choices that protect your well-being.

The holidays are a time to celebrate—not to prove, perform, or compete. Embrace the season in a way that feels authentic to you, and let go of the pressure to “get it right.” You are enough, exactly as you are.

Women, Mental Health, and Executive Functioning: How Common Mental Health Experiences Impact Our Ability to Manage Everyday Life

Executive functioning is one of those psychological terms that gets thrown around a lot, but what does it really mean, and why does it matter? In simple terms, executive functioning refers to the mental processes that help us plan, focus attention, remember instructions, and manage multiple tasks successfully. It’s like the brain’s air traffic control system, helping us navigate the complexities of daily life. When we think of executive functioning impairment, we often think of ADHD, which is accurate. But for many women, depression, anxiety, and trauma can seriously disrupt these mental processes, leading to a cascade of challenges in work, relationships, and personal goals.

If you’ve ever felt overwhelmed by a to-do list, struggled to manage your time, or felt paralyzed by indecision, you’re not alone. These are common symptoms of impaired executive functioning, particularly for women who are often juggling multiple roles and responsibilities. This blog will explore how mental health conditions can affect executive functioning, what that looks like in women, and strategies to manage day-to-day life when your brain feels foggy, disorganized, or just plain tired.

What is Executive Functioning?

Executive functioning refers to a set of cognitive skills that allow us to manage our thoughts, actions, and emotions to achieve goals. These skills include:

• Planning and Organization: Creating and following a plan to complete tasks, whether it’s preparing a meal, planning a trip, or managing a work project.

• Working Memory: Holding information in your mind temporarily to use it, like remembering a phone number long enough to dial it or keeping track of a conversation while listening and formulating your response.

• Impulse Control: The ability to think before you act, like pausing before sending an angry email or resisting the urge to procrastinate.

• Emotional Regulation: Managing your emotional responses, like calming yourself down when upset or motivating yourself when feeling low.

• Flexible Thinking: Adapting to new situations and being able to see different perspectives, which helps with problem-solving when things don’t go as planned.

• Self-Monitoring: Recognizing your performance and adjusting your behavior, such as catching mistakes as you make them or noticing when you’re off track.

We use these skills every day, often without even realizing it. From getting out the door on time in the morning to managing work deadlines and keeping the house in order, executive functioning helps us stay on top of life’s many demands. But when depression, anxiety, or trauma are in the picture, these skills can take a significant hit.

Every day activities such as managing spending, budgeting, and impulsive shopping may be executive functioning skills that are impacted negatively by one’s mental health.

How Depression, Anxiety, and Trauma Affect Executive Functioning

For women, the impact of depression, anxiety, and trauma on executive functioning can be profound. These mental health conditions don’t just affect our mood; they can also disrupt the cognitive processes that allow us to function effectively. Here’s how each of these conditions can interfere:

• Depression: Depression often comes with a heavy fog of fatigue, lack of motivation, and difficulty concentrating. It’s like trying to think through quicksand—everything feels slower and harder. Tasks that were once manageable, like paying bills, returning phone calls, or even getting dressed, can feel overwhelming. This cognitive slowing is part of why depression can be so disabling; it doesn’t just make you feel sad; it disrupts your ability to think and function.

• Anxiety: Anxiety keeps the brain on high alert, constantly scanning for danger, which can interfere with focus and decision-making. When your brain is consumed with worry or fear, it’s hard to prioritize tasks, remember details, or complete projects. Everyday responsibilities like grocery shopping or responding to emails can feel like monumental tasks, often leading to avoidance behaviors that further compound stress.

• Trauma: Trauma, especially complex or developmental trauma, can severely impact executive functioning. The brain’s survival mechanisms, which are crucial during traumatic events, can get stuck in overdrive, making it difficult to concentrate, regulate emotions, or manage time effectively. For trauma survivors, everyday tasks can feel disjointed and fragmented, like trying to piece together a puzzle with missing parts.

What Low Executive Functioning Looks Like in Women

Women are often expected to be the organizers, caretakers, and multitaskers of their families and communities. When executive functioning is impaired, these expectations can feel impossible to meet, leading to guilt, shame, and a sense of failure. Here’s what low executive functioning might look like in women:

• Struggling with Time Management: You constantly feel like you’re running late or can’t keep up with your schedule. You may have a hard time estimating how long tasks will take, leading to chronic lateness or rushing.

• Difficulty Prioritizing Tasks: Your to-do list feels overwhelming, and you’re unsure where to start. You might spend hours on low-priority tasks while avoiding the more critical ones, only to feel even more overwhelmed later.

• Procrastination and Avoidance: You put off tasks until the last minute because starting feels too daunting. This might involve avoiding difficult conversations, delaying household chores, or ignoring work deadlines.

• Emotional Outbursts or Shutdowns: When things don’t go as planned, you might find yourself reacting more intensely than you’d like—either with anger, tears, or complete emotional shutdown. Regulating emotions feels especially difficult when stressed or tired.

• Forgetfulness and Disorganization: You lose track of important details, misplace items, or forget appointments. You might have a dozen post-it notes scattered around, yet still feel disorganized.

• Mental Fatigue: Simple tasks feel exhausting. You often feel drained and unfocused, even after seemingly small efforts, making it hard to get through the day.

These symptoms can make it difficult for women to meet the demands of work, family, and personal life, leading to a cycle of frustration and self-blame. But there are ways to manage these challenges and support yourself through the tough times.

Strategies to Manage Daily Activities with Lowered Executive Functioning

Managing life with impaired executive functioning doesn’t mean you’re failing; it means you need a different set of tools. Here are some strategies that can help:

1. Simplify Your To-Do List

If your to-do list feels overwhelming, try breaking it down into smaller, manageable steps. Instead of “clean the house,” write down specific actions like “put laundry in the washer” or “clean kitchen countertops.” Prioritize tasks by importance and urgency, and focus on one small step at a time. Apps like Todoist or Trello can help you organize and visualize tasks in bite-sized chunks, reducing the feeling of overwhelm.

2. Use Timers and Reminders

Time blindness, or losing track of time, is common when executive functioning is impaired. Use timers, alarms, or calendar reminders to help you stay on track. Set a timer for 10-15 minutes and commit to working on a task for just that time—knowing you have a set endpoint can make starting feel less daunting. You can also use reminders to prompt self-care activities, like taking medication, drinking water, or stepping outside for a break.

3. Create Routines That Work for You

Routines provide structure, but they don’t have to be rigid or perfect. Start by creating simple, repeatable routines for key parts of your day, like morning or bedtime. For example, a morning routine could include just three steps: get dressed, have coffee, and write down your top three tasks for the day. Keep routines flexible and forgiving; the goal is to create some predictability, not perfection.

4. Set Up a “Command Center”

Create a dedicated space for organizing your daily tasks—this could be a corner of your kitchen, a desk, or even a digital space on your phone. Use a planner, whiteboard, or bulletin board to keep track of appointments, deadlines, and important reminders. This centralized “command center” can serve as your brain’s external hard drive, helping to reduce cognitive load and keep things visible and accessible.

5. Practice Self-Compassion and Adjust Expectations

When your executive functioning is low, it’s easy to fall into the trap of self-criticism. Practice self-compassion by acknowledging that you’re doing the best you can with the tools you have. Adjust expectations for yourself—some days, it’s okay if you only accomplish one or two things. Remind yourself that your worth is not tied to productivity, and celebrate small victories along the way.

How Therapy Can Help

Therapy can be a vital tool in managing the impact of depression, anxiety, and trauma on executive functioning. Here are some therapeutic approaches that can be particularly helpful:

1. Cognitive Behavioral Therapy (CBT)

CBT helps you identify and challenge negative thought patterns that contribute to avoidance, procrastination, and self-criticism. It also provides practical strategies for improving time management, organization, and decision-making. CBT can help you develop healthier coping mechanisms and build the skills needed to navigate daily challenges.

2. Dialectical Behavior Therapy (DBT)

DBT, originally developed for individuals with emotional regulation difficulties, teaches skills like mindfulness, distress tolerance, and emotional regulation. These skills can be incredibly helpful for managing the overwhelming emotions that often accompany executive functioning struggles.

3. Trauma-Focused Therapies (EMDR, Somatic Experiencing)

For those whose executive functioning issues are linked to trauma, therapies like Eye Movement Desensitization and Reprocessing (EMDR) or Somatic Experiencing can help reprocess traumatic memories and release the body’s stored stress response. This can lead to improved cognitive functioning, reduced anxiety, and greater overall resilience.

4. Occupational Therapy (OT)

Occupational therapy focuses on helping individuals improve their ability to perform daily activities. An OT can help you develop personalized strategies for organization, time management, and task completion, taking into account your unique challenges and strengths.

Reclaiming Your Daily Life

Executive functioning is the foundation that helps us navigate daily life, but when depression, anxiety, or trauma are in the mix, these skills can feel shaky and unreliable. For women, the pressures of managing multiple roles can exacerbate these challenges, making it feel like you’re constantly falling behind.

But struggling with executive functioning doesn’t mean you’re lazy or incapable—it means your brain is under stress, and you need compassion, support, and tools that work for you. By implementing small, practical strategies, seeking therapeutic support, and being gentle with yourself, you can manage these challenges and start reclaiming your daily life, one step at a time.

Remember, you are more than your productivity. You are resilient, capable, and deserving of kindness, both from yourself and others. Your worth is not measured by how flawlessly you juggle tasks but by the courage you show in navigating the complexities of life with authenticity and grace.

holding on tight, right beside you

Content Warning: Election Results

There are a handful of phrases that we as therapists use so regularly I think most of us are probably internally chuckling or rolling our eyes at ourselves whenever we utter them to a client. But they get repeated because they’re just that good. Among them “Where do you feel that in your body?” or “Two conflicting things can be true!” Another that has been coming up a lot since the results of last Tuesday night is “Feeling your feelings won’t make them worse.”

As therapists, one of our primary jobs is to help people feel their feelings without becoming consumed by them. The fear, or anxiety, that by letting ourselves really feel will lead to catastrophe or implosion or self-destruction begets more anxiety, more fear, more dissociation. By feeling our feelings, our brains and body are able to process the chemicals and physical responses that come along with those emotions and return to homeostasis. From there we can move on with our lives or take action. Feeling the feeling is both a function of learning, and of regeneration.

As you can imagine, social media is plentiful with hot takes on how we should feel since Tuesday. You should be grieving; you should be finding joy; you should be angry; you should be taking action; you should be hopeful; you should be despondent. And there of course is a rebuttal for each of these options. As therapists, we know the truth. Grief is not a linear process. And all of these feelings are normal. We will feel each of them, and at times, we will feel nothing. I know personally I was tearful on Wednesday morning talking to our team at our monthly meeting. Writing this, to be honest, I’m pretty burnt out.

That meeting, however, was a reminder that healing happens in community. And it is also where we harness strength. While we shared our unique responses to what had just happened, our therapist, Madison Eagle, LSW, offered this: “Revolution and progress has been and always will be found in community and connection.”

Whether that is with your neighborhood, your school district, your chosen family. There is power in the collective, and by nature, a collective is a gathering of whatever resources we each have to support the whole, and find a way forward.

We want our practice to be one of those places. Whether for our therapists who come together as professionals who are passionate about individual mental health as well as the systems and policies that impact our clients, or, tangentially, for our clients, who we hope feel safety and connection when working with our clinicians.

The longing for community was exactly why Wild Hope was created. I was working alone during the pandemic when everything was uncertain and we were all isolated. And at the time, witnessing another campaign cycle that was very similar to this one.

Of course that election had a different outcome. But that didn’t mean that everything was ok, or that our clients didn’t still suffer because of systemic oppression or harmful policies. Especially in Ohio, our colleagues at organizations like NASW-OH, The Ohio Women’s Alliance, Chamber of Mothers, and countless others were fighting every day to make people safer in our state.

The phrase “wild hope” was taken from a poem written by a fearless poet who also happens to be one of my best friends, Katie Schmid. The reason I used it as the name for the practice is because at the time that’s what it felt like I was doing: hoping, wildly. Hoping, when maybe I shouldn’t have been. But, I knew at the time I was never going to stop doing it. And so Wild Hope Therapy was born.

First of all, it is very important to mention that I am a white, straight, married, middle class, cis-gender woman, writing to you from a cozy, progressive-leaning suburb. That’s quite a list. My ability to muster energy or optimism is not only made possible by that comprehensive panel of privilege, it is absolutely essential that I, and those like me, mine all of that extra capacity bestowed on us, and use it to fight on behalf of those who are much more weathered and worn down–and in much more danger–than we are.

Even so, I’m not exactly feeling super hopeful on my own right now. Trying to find joy and experience gratitude, yes–but I don’t have to tell you about the fear and despair that has been hovering the past week. Having a community, however, means we can bring the little hope we do have and put it all together so that we can pull each other along.

So if our practice is one of those communities or collectives for you, know that we will be here no matter what. Holding space for our clients; advocating for our community; and supporting each other. And we will all put our bits of hope and scraps of resilience together so that we have a whole mountain of whatever it is that keeps us going.

In the words of the radiant and hilarious Jessica Williams, ““No matter what happens, we have to throw our arms around the people who need us the most and hold the f— on.”

Holding on tight, right beside you,

Stephanie Purdom, LISW-S, PMH-C
Founder + Executive Director of Wild Hope Therapy

Understanding Intrusive Thoughts: A Compassionate Guide for Women

Uninvited Guests: Understanding and Managing Intrusive Thoughts

Intrusive thoughts can feel like the unwelcome guest who barges into your mind, uninvited and completely out of place. They’re often bizarre, disturbing, or downright upsetting, leaving you wondering, “Why on earth did I just think that?” For many women, these thoughts can trigger shame, anxiety, or fear, leading to the mistaken belief that something is deeply wrong with them. But here’s the truth: intrusive thoughts are incredibly common, and having them does not make you a bad person.

Learning what intrusive thoughts are, why they occur, and how they often impact women in particular can help to shed light on this upsetting but common experience, and minimize shame. By understanding and normalizing these experiences, you can begin to loosen the grip these thoughts have on your life. We’ll also explore effective therapies and practical tools that can help you manage and move past intrusive thoughts with compassion and confidence.

What Are Intrusive Thoughts?

Intrusive thoughts are unwanted, involuntary thoughts, images, or urges that pop into your mind without warning. They often  feel disturbing because they contradict your values, morals, or sense of self. These thoughts can involve violent, sexual, or taboo themes that are completely out of character, making them especially distressing. The key is that these thoughts are not reflective of your true desires or intentions—they are just thoughts, and they don’t define who you are.

Intrusive thoughts are part of being human. Research suggests that about 94% of people experience unwanted, intrusive thoughts at some point in their lives. For women, these thoughts can be especially troubling, given the societal expectations of perfection, caregiving, and emotional regulation. It’s important to remember that intrusive thoughts are not a sign of failing or being broken—they’re a normal (albeit uncomfortable) part of how the brain works.

Types of Intrusive Thoughts Commonly Experienced by Women

While anyone can experience intrusive thoughts, certain themes are particularly common among women, often reflecting societal pressures, fears, and responsibilities unique to their roles. Here are some types of intrusive thoughts that women typically experience:

1. Harm-Related Thoughts*

Thoughts of accidentally hurting yourself or someone you love are extremely common among women, and new mothers in particular. These thoughts are horrifying precisely because they are the opposite of what you want. The more you care, the more distressing these thoughts can feel.

*If you are experiencing thoughts of harming yourself or others, please seek emergency support by calling 911 or going to the nearest emergency room. 

2. Sexual Thoughts

Unwanted sexual thoughts can involve taboo or inappropriate themes, such as sexual thoughts about family members, strangers, or even children. These thoughts often cause intense shame and confusion, as they are completely out of line with a woman’s true desires or values.

3. Relationship-Related Thoughts

Intrusive thoughts about relationships often revolve around doubts or fears, like suddenly questioning if you love your partner or having vivid images of infidelity, even when there’s no desire or intention behind them. These thoughts can create unnecessary anxiety and self-doubt in relationships.

4. Moral or Religious Thoughts

Women who hold strong moral or religious beliefs might experience intrusive thoughts that contradict their values, such as blasphemous or sacrilegious thoughts. These thoughts can create a deep sense of guilt, as they feel at odds with one’s sense of identity and faith.

5. Self-Doubt and Perfectionism

Intrusive thoughts often target a woman’s sense of worth or competence, especially in roles where societal pressure is high, like motherhood, caregiving, or professional life. Thoughts like “I’m failing,” “I’m a bad mother,” or “I’m not good enough” are common and can be deeply discouraging.

Why Do We Have Intrusive Thoughts?

Intrusive thoughts are a natural part of how the brain processes information, particularly when you’re under stress or anxiety. They often occur when the brain misfires while trying to protect you from harm, generating thoughts that are irrelevant or inappropriate to the moment. It’s like an overactive alarm system that keeps going off, even when there’s no real danger.

For women, intrusive thoughts can be influenced by hormonal changes, societal expectations, and the mental load of caregiving and multitasking. Perfectionism, fear of judgment, and the pressure to always be “good enough” can amplify the distress these thoughts cause. Understanding that these thoughts are not a reflection of who you are is crucial in breaking the cycle of anxiety and self-blame.

Therapies That Help with Intrusive Thoughts

Several therapeutic approaches are highly effective in addressing intrusive thoughts, helping you understand and manage them without getting stuck in cycles of fear or shame. Here are some therapies that have been shown to help:

1. Cognitive Behavioral Therapy (CBT)

CBT is one of the most widely used therapies for intrusive thoughts. It helps you identify and challenge unhelpful thought patterns, teaching you to reframe and respond to intrusive thoughts with less distress. Instead of trying to eliminate the thoughts (which usually doesn’t work), CBT helps you change your relationship with them, reducing their impact.

2. Exposure and Response Prevention (ERP)

ERP, a specific type of CBT, is especially effective for intrusive thoughts related to obsessive-compulsive disorder (OCD). It involves gradually exposing yourself to the thoughts or situations that trigger anxiety while resisting the urge to perform any compulsive behaviors in response. Over time, this reduces the fear response and teaches the brain that the thoughts are not dangerous.

3. Acceptance and Commitment Therapy (ACT)

ACT focuses on accepting intrusive thoughts without judgment and committing to actions that align with your values. Instead of fighting the thoughts, ACT encourages you to make space for them while still moving forward with what matters to you. It’s about accepting your thoughts as just that—thoughts—without letting them dictate your actions or self-worth.

4. Mindfulness-Based Cognitive Therapy (MBCT)

MBCT combines mindfulness practices with cognitive therapy techniques to help you stay present and non-reactive to intrusive thoughts. Mindfulness helps you observe your thoughts without becoming entangled in them, reducing their power and influence over your emotional state.

Tools for Managing Intrusive Thoughts

While therapy is invaluable, there are also practical tools you can use daily to manage intrusive thoughts. Here are some strategies that can help:

1. Label the Thought as “Intrusive”

The first step in managing intrusive thoughts is recognizing them for what they are—just thoughts, not truths. When an intrusive thought pops up, try labeling it as “intrusive” or “just a thought.” This helps create distance between you and the thought, reminding you that it’s not an indication of your desires, intentions, or character.

2. Practice Mindful Detachment

Instead of engaging with the thought, practice observing it as if you’re watching clouds pass by in the sky. You don’t have to react, argue, or push it away. Mindful detachment involves acknowledging the thought and letting it drift on its own, without judgment or attachment.

3. Reframe the Thought’s Meaning

Intrusive thoughts are often distressing because of the meaning we assign to them. Instead of seeing a thought as dangerous or shameful, try reframing it: “This thought doesn’t define me,” or “Having this thought doesn’t mean anything about who I am.” This reframe helps reduce the emotional charge of the thought.

4. Use Grounding Techniques

When an intrusive thought feels overwhelming, grounding exercises can help bring you back to the present moment. Try focusing on your senses: name five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste. This simple exercise can disrupt the thought spiral and anchor you in the here and now.

5. Don’t Avoid the Thoughts

It’s natural to want to avoid or suppress intrusive thoughts, but avoidance often makes them stronger. Instead, gently allow the thought to be there without fighting it. Remember, the more you try to push it away, the more your brain sees it as a threat. Allowing the thought to exist without resistance can reduce its frequency and intensity over time.

Break Free from the Grip of Intrusive Thoughts

Intrusive thoughts can be unsettling, but they are a common part of the human experience—especially for women navigating the complexities of modern life. Understanding that these thoughts are just a quirk of the mind, not a reflection of your character, is the first step toward reclaiming your peace of mind.

Therapies like CBT, ACT, and mindfulness offer powerful ways to shift how you relate to these thoughts, helping you break free from their grip. And with practical tools like mindful detachment, reframing, and grounding techniques, you can manage intrusive thoughts in your daily life, reducing their impact on your mental health and well-being.

Above all, remember that you are not alone in this experience. You are not defined by your thoughts, and you have the power to live a full, meaningful life, even in the presence of these unwelcome mental intrusions. You are strong, resilient, and worthy of compassion—from others and, most importantly, from yourself.

Managing Stress, Setting Boundaries, and Taking Action: Mental Health in an Election Cycle

Election cycles bring a whirlwind of emotions, conversations, and headlines. While democracy thrives on engagement, these seasons often bring unique challenges, particularly for women and female-identifying individuals in Ohio. With topics like reproductive health, family rights, economic stability, and healthcare at the forefront, it’s natural to feel both hopeful and burdened by the weight of these issues. It is important for our own emotional well-being, and our capacity to keep doing the things that we care about, that we recognize how challenging these times can be.

During these cycles, it’s essential to safeguard your mental health while staying engaged with the issues you care about. By setting boundaries, staying mindful of your needs, and discovering ways to take action that align with your capacity and values, you can make it through the season with a balanced sense of agency and calm.

1. The Emotional Landscape of Election Seasons

Election cycles can amplify feelings of anxiety, anger, and fear, especially when personal issues or those affecting loved ones feel uncertain. Ohio’s political climate often brings up topics that deeply impact women’s rights, family dynamics, healthcare, and economic opportunities. This election season, you may find yourself thinking about your future, the well-being of your children, the safety and rights of those close to you, and the kind of society you hope to build.

For many women, election cycles aren’t just political — they’re personal. The outcome may impact access to reproductive healthcare, rights for marginalized communities, and policies affecting mental health services and support systems. These issues can lead to a sense of urgency to engage, advocate, and sometimes even to brace oneself for outcomes that may feel out of control.

2. Setting Healthy Boundaries

While you might value staying informed and engaged, constant exposure to news updates, social media feeds, and heated discussions can lead to burnout. Establishing boundaries allows you to be present and intentional in how you absorb information, protecting your mental well-being along the way.

How to Set Boundaries:

• Control Media Consumption: Consider scheduling time to check the news rather than having it on throughout the day. Perhaps mornings or evenings work best for you. This can help reduce the emotional toll of constant updates while ensuring you’re informed.

• Curate Social Media: Social media can amplify the intensity of election seasons. Take time to mute, unfollow, or “snooze” accounts that trigger stress, anger, or anxiety. Remember that it's okay to take breaks from platforms altogether.

• Limit Political Conversations: With family, friends, or colleagues, feel empowered to set boundaries around political discussions. You can express this gently, such as, “I appreciate our conversations, but I’d prefer to focus on lighter topics today.” This approach can protect your relationships and prevent unnecessary stress.

3. Handling Differences with Loved Ones

Election seasons often bring out strong opinions, and it’s common to find differences in beliefs among family members, friends, or even romantic partners. Navigating these differences with respect, understanding, and clear communication is essential for maintaining your mental health and keeping relationships intact.

Tips for Managing Conversations:

• Set Boundaries with Empathy: Let loved ones know that, while you respect their views, you may not want to engage in political discussions at this time. This can be especially useful when conversations veer into areas that feel particularly triggering.

• Practice Active Listening: When engaging in political discussions, using active listening techniques can help keep conversations respectful. Phrasing responses with “I understand where you’re coming from, and I feel…” can help avoid confrontational exchanges and preserve mutual respect.

• Recognize When to Step Back: If a conversation is becoming too intense, don’t hesitate to step away. Protecting your mental well-being is paramount, and sometimes taking a pause or leaving a heated discussion is the best way to care for yourself.

4. The Power of Taking Action

When the issues feel too overwhelming, taking action can provide a sense of agency and purpose. Engaging in activism or advocacy — even on a small scale — can help channel feelings of frustration or anxiety into something constructive. When done mindfully, taking action can serve as a grounding and fulfilling practice.

Ways to Take Action:

• Engage in Local Advocacy: Whether it’s reproductive rights, healthcare access, or educational reforms, local organizations in Ohio are always in need of support. Volunteering with a group that aligns with your values can provide a sense of community and accomplishment.

• Register to Vote and Help Others: Voting is a powerful way to make your voice heard, but helping others access voting can also have a broad impact. Consider helping friends or community members with voter registration or sharing resources on polling locations.

• Practice Relational Activism: This can mean sharing your values through meaningful conversations with people you trust, raising awareness gently, and building bridges. Instead of solely debating, focus on connecting through shared concerns. Relational activism reminds us that change often starts with compassion.

5. Practicing Self-Compassion and Prioritizing Self-Care

During election seasons, it’s easy to feel personally responsible for making a difference. But it’s essential to give yourself grace and remember that you’re only one person — your mental health is just as important as the causes you care about.

Tips for Self-Compassion:

• Acknowledge Your Limits: Recognize that it’s okay to step back if things feel too overwhelming. Taking time for yourself is a strength, not a weakness.

• Remember, You’re Not Alone: Many people feel similarly during election cycles. You are part of a community of individuals who are trying to find balance, care for themselves, and make a positive impact.

• Seek Support When Needed: Therapy can provide a nonjudgmental space to explore your feelings around election-related stress, discover ways to cope, and develop strategies for resilience.

6. Building a Routine of Self-Care

When the external world feels chaotic, creating a stable routine for yourself can be grounding. Prioritizing self-care during election cycles can provide a safe, nurturing space for you to return to each day.

Self-Care Strategies to Consider:

• Mindfulness and Meditation: Practicing mindfulness can help you stay present and reduce anxiety. Even a few minutes of deep breathing or meditation each day can bring a sense of calm.

• Physical Movement: Exercise is a powerful stress-reliever. It can be as simple as a walk outside, a short yoga session, or even a dance break to reset and lift your mood.

• Creative Outlets: Engaging in activities like writing, drawing, or crafting can provide an emotional release. Journaling, in particular, can help you process emotions related to election stress and gain clarity.

7. Recognizing When to Seek Professional Help

If election-related stress becomes too intense or begins to impact your daily life, seeking professional support can be incredibly beneficial. Therapy offers a compassionate, nonjudgmental environment where you can explore your feelings, set boundaries, and learn tools to navigate emotionally challenging times.

Issues like reproductive healthcare, healthcare access, and family rights often feel deeply personal, and we’re here to provide a safe space for you to process these experiences. Whether you’re feeling isolated, frustrated, anxious, or hopeful, our therapists are committed to helping you find a path forward that feels manageable, hopeful, and empowered.

8. Hope, Resilience, and Connection

While election cycles may stir up difficult emotions, they can also serve as a reminder of resilience and community. Election seasons can be a time for connecting with those who share your values, a moment to reflect on the changes you wish to see, and an opportunity to engage in ways that feel meaningful to you. Together, we can acknowledge the weight of these issues, protect our mental health, and continue to support one another through challenging times.

At Wild Hope Therapy, we believe in your resilience, and we’re here to support you every step of the way. Our practice isn’t here to tell you how to feel or what to believe; we’re here to help you navigate this journey in a way that honors your well-being and the issues that matter most to you. Your voice, your actions, and your mental health all play a vital role in creating the future you envision — and that’s something worth holding onto.

testimony provided for HCR16

Chair Pavliga, Vice Chair White, Ranking Member Brewer and members of the House Behavioral Health Committee. Thank you for allowing me to provide proponent testimony on HCR16, recognizing the importance of perinatal mental health.

Hello, my name is Sara Parko, and I am a licensed social worker and certified perinatal mental health therapist. I currently work in private practice where I also serve as the perinatal education manager to support our clinical team and I manage a caseload of over ninety-percent perinatal clients. I have also had the opportunity to support the perinatal population in both community mental health and hospital settings.

Today, my hope is to add color and context to the perinatal mood and anxiety disorders that impact maternal mental health and wreak havoc on families. These conditions are ones that, when appropriately supported by a mental health professional, are treatable and can improve outcomes for the birthing person, baby, partner and family. 

Several years ago I met with a woman who experienced postpartum psychosis, a rare disorder, but incredibly serious. When experiencing postpartum psychosis the mother had delusions and hallucinations related to her infant. The situation became grave when the mother stopped sleeping for days at a time, began to neglect the baby, and spent her time entertaining the voice in her mind. This mother also had three other children, and thankfully, a very observant partner. The woman was hospitalized, however, this experience is fraught with emotions as it also ended her breastfeeding journey and further delayed bonding with her child. 

I actually met this woman when she found out that she was pregnant with her fifth child, and she was appropriately terrified to re-experience psychosis. We processed through the trauma that occurred and helped her to heal from the past before welcoming her next baby. To manage the risk of psychosis, we focused on building a network of support to reduce stress and triggers, collaborated with her care team, and also developed a plan, should psychosis occur, that supported her autonomy and provided her with a sense of empowerment. She did not re-experience postpartum psychosis. 

Another woman’s story I’d like to share with you today is from 2020. While this story is one that is directly complicated by the pandemic, the ongoing fears related to germs, illness and social support or settings remain themes in my work as we all process the impact of this universal trauma on our lives. 

Although this woman had a previous history of anxiety, she had never sought treatment, doing her best to manage her symptoms - preferably masking or hiding them from others. During her pregnancy she constantly worried about the baby and refused to allow herself to connect with the pregnancy and celebrate for fear of the risk of miscarriage, and then stillbirth. This was made easier by the lack of social commitments and opportunities at the time. She also reported that when she went to her midwife appointments she would make sure she was put together - well-dressed and make-up done - to ensure again that no one noticed she was struggling. This mother was also fearful that if she could not be perfect, “they” would take her baby away. 

When she welcomed her baby into the world her fear of losing the baby diminished; but a new fear replaced it with constant rumination and intrusive thoughts. When I met her she was four weeks postpartum, her anxiety and fear of COVID had made it impossible to ask others for help in the home, she was struggling to breastfeed her baby who was also not gaining weight as her pediatrician would like, she struggled to sleep and feed herself as well, she had no confidence in herself as a mother, and reported that she believed “everyone would be better off without her.” Her anxiety made it impossible to make decisions; impossible to care for herself or her child; impossible for her to see hope for the future. 

We met twice a week and focused on small tasks to support basic needs. In therapy we worked on developing coping skills to manage intrusive thoughts and decrease the client’s anxiety. This client’s symptoms made it impossible for her to return to work as planned and so I supported her in filing for short term disability. After several weeks of therapy she allowed her mother to come into her home to help her and her partner, she began sleeping, she felt more confident learning her infant’s cues and began bonding more with her child, she made decisions for herself and her baby regarding feeding that felt genuine and healthy, she learned to push back on intrusive thoughts and reduce rumination, and overtime she developed an improved sense of self. 

I have hundreds of stories like these. Stories of new parents struggling to survive, challenged by their mental health as they take on the difficult transition of parenting. Stories of birthing people with postpartum depression, postpartum anxiety, perinatal obsessive compulsive disorder, and birth trauma.

The final story I would like to share with you today, is mine. The reason I entered this treatment space is because of my friend. President of our sorority - strong, thoughtful, kind. She was the type of person who you couldn’t not smile around. I remember when I learned that she had completed suicide, leaving behind a loving husband and 11-month old daughter. It’s my hope that no one ever feels as alone, defeated or helpless as my friend must have. It’s my hope that I can do what I can to ensure birthing persons have support for their mental health - so that children don’t have to grow up without their mothers. 

Thank you again for allowing me to provide testimony on HCR16, and I am happy to take any questions you may have at this time.

highlighting the critical need for change during black maternal mental health week

**TRIGGER WARNING: this post contains sensitive content related to perinatal psychosis, suicide and murder and may not be appropriate for all audiences.

Written by Chahdael Foreman, LSW

My career as a perinatal mental health therapist came out of my experience with postpartum anxiety and OCD as a Black woman. I experienced intrusive thoughts of my baby getting hurt and excessive anxiety which was misunderstood as psychosis and led to a very traumatic experience for myself and my family. I was lucky enough to be evaluated by a culturally competent provider who considered my entire environment and experiences before placing me into a clinical box, so to speak. 

As Black Maternal Mental Health Week kicks off everywhere in the US, we are reminded of the additional challenges that Black and African American women and birthing persons face while pregnant and parenting simply for the color of their skin. There is a deep mistrust of the healthcare system due to historical and systemic prejudices that directly impact treatment and often perpetuate groundless stereotypes about black bodies. These challenges overflow into mental health as well. While activities such as advocacy, awareness building, and social discourse have increased the role of culture and race within mental health, too many individuals still fall through the cracks. 

This week, on April 11, 2024, news broke from the LA area of a young Black woman, Danielle Ayoka Johnson, taking her life and those of her partner and children (ages 9 and 8-months), due to fears of spiritual warfare. The news coverage captures Johnson’s paranoia around the eclipse that occurred on April 8, due to her profession as an Astrology influencer. While it will likely be very difficult to understand this story in totality as a result of Johnson’s suicide; we can’t ignore the signs and symptoms of postpartum psychosis that are apparent within this report. 

Postpartum or perinatal psychosis is the most severe and most rare mental health complication in the perinatal period. According to Postpartum Support International, “perinatal psychosis occurs in approximately 1 to 2 out of every 1,000 deliveries, or approximately .1 -.2% of births. The onset is usually sudden, most often within the first 2 weeks postpartum, but can appear any time in the first year.” 

Symptoms include:

• Delusions or strange beliefs

• Hallucinations (seeing or hearing things that aren’t there)

• Feeling very irritated

• Hyperactivity

• Severe depression or flat affect

• Decreased need for or inability to sleep

• Paranoia and suspiciousness

• Rapid mood swings

• Difficulty communicating at times

“The most significant risk factors for postpartum psychosis are a personal or family history of bipolar disorder, or a previous psychotic episode,” according to Postpartum Support International.

It is important to note that postpartum psychosis, like all maternal mental health complications, is treatable. However, in order to treat any mental health condition, we must first be able to identify the concern and access support. 

As a perinatal mental health therapist, it is so important for new parents and support people to understand and seek services at the first signs of mental distress. Educating yourself about symptoms, or early warning signs, and taking action can help to ensure prompt treatment. Early intervention can play a role in reducing the severity of an illness and interruptions in one’s life. 

Perinatal mood and anxiety disorders impact 1 in 5 women and birthing persons and 1 in 10 fathers. While these birth complications don’t discriminate based on race or ethnicity, the rates for Black and African American women are almost twice that of their white counterparts, in large part due to the systems we have in place and racial bias. 

The week of April 11-17, 2024 is Black Maternal Health Week presented by The Black Mamas Matter Alliance (BMMA). BMMA “is a Black women-led cross-sectoral alliance that centers Black mamas and birthing people to advocate, drive research, build power, and shift culture for Black maternal health, rights, and justice.” This organization is bringing important issues to light and creating space for thoughtful and system-changing conversation in the space of reproductive justice. We support and hold space for this important week of recognition because while we don’t know Johson’s full story, we can observe that she was a young Black mother who likely needed more screening, intervention and support that she and her family received. 

If you or someone you know is experiencing a shift in mood or mental health concerns in the perinatal period, please know you are not alone and help is available. 

Postpartum Support International

Perinatal Outreach and Encouragement for Moms (POEM) 

Edited by Sara Parko, LSW, PMH-C

how a resilient kid becomes a happy adult

By Sara Parko, LSW, PMH-C

Recently I picked up my copy of “Good Inside” by Dr. Becky Kennedy @drbeckyatgoodinside for the umteenth time. I’ll own it, I’m one of those readers with a toppling stack of half read books and a lot of good intentions.

I try to make a point to read any book I recommend first, but it’s been a couple years since I’ve conquered this one cover to cover. Thankfully, Libby by @overdrive.inc_ for the win! This Mama loves an audiobook! 

So here we all are, reflecting on happiness together and whether or not we want our children - or our adult selves - to have it. 

Yes, that’s one thing I believe gets missed in parenting books; we’re often parenting ourselves too. So even if you don’t have children, or they're all grown up, this is still for you. 

Dr. Becky posits in chapter six that “cultivating happiness is dependent on regulating distress” (p. 62). It doesn’t matter if you’re 6, 16, 36 or 60, this applies. “Regulation first, happiness second” (p. 63). This is the process of developing and practicing resilience.

Resilience is our ability to experience emotion and stay grounded. To feel a negative emotion (stress, failure, adversity) and not feel bowled over by it but rather that we’re able to allow that emotion and to find our way forward. 

When we focus on our children’s “happiness,” Dr. Becky explains, we’re more inclined to solve their problems, rather than allowing them the chance to solve it themselves. While this feels good for both of us (parent and child) in the short run, the long term implication is that our children do not learn what to do when faced with challenges, failure, disappointment, or other difficult situations. 

In our effort to support, we can also invalidate–when we dismiss an emotion with an encouraging “you’ll be okay,” when we minimize an experience with “oh it’s not that big of a deal, there will be other chances…” Dr. Becky notes that when we push away the bad feeling for our child, “we think we are helping, but what our child hears is, ‘I should not feel upset. When I feel uncomfortable, my job is to make my way into comfort as soon as possible.’” (p. 67).

But what if instead of trying to protect, we focus on preparing our children (and ourselves) for the tough stuff, the hard times, the challenges of life? 

We can start by creating space for distress. Talking about disappointments creates opportunities for children to learn from them, allowing for growth through reflection as well as fostering connection when they aren’t “perfect.” Kids learn, in turn, that their job isn't to be happy all the time and they can be accepted and supported through difficult times. This promotes emotional regulation by offering an outlet through supportive conversation, giving children the chance to express their hard feelings appropriately. 

As adults we can practice this skill and build our own resilience as well. What would it be like for you to sit with and recognize your own distress without shame or guilt? What if you turn to a trusted friend or support person to talk it out? How would you feel different about, or even grow from, a difficult situation that you were given permission to acknowledge was hard?

What if our parents, and in turn we as parents, shared Dr. Becky’s dream: “I want my child to be able to cope with whatever the world throws her way. I want her to feel supported in distress when she’s younger so she can support herself when she’s older” (p. 69). 

Read more about Good Inside by Dr. Becky Kennedy.

ten books about love

There’s all sorts of ways to show, experience, engage with, explore and talk about love.

We’ve collected ten books we love recommending and reading that do just that. So in no particular order, here are ten books that look at love within your most important relationships - including yourself.

1. Come as You Are: The Surprising New Science that Will Transform Your Sex Life by Emily Nagoski Ph.D. - We love this deep dive into the science of sex and the female body. Through the exploration and integration across multiple disciplines, this book explores how “stress, mood, trust, and body image” impact desire, pleasure and a women’s sexual wellbeing. 

2. Sex Talks: The Five Conversations That Will Transform Your Love Life by Vanessa and Xander Marin - You know communication in a relationship is important, but does that mean we have to talk about sex too? Pick this book up to learn more about connection that leads to pleasure in your intimate relationship. 

3. How to Be Alone: If You Want To, and Even If You Don't by Lane Moore - because not everyone wants to spice it up this Valentine’s Day, Good Reads says “How to Be Alone is a must-read for anyone whose childhood still feels unresolved, who spends more time pretending to have friends online than feeling close to anyone in real life, who tries to have genuine, deep conversations in a roomful of people who would rather you not.” 

4. What About Us? by Karen Kleiman - check out Wild Hope’s social media channels every Sunday this month to see why we believe this book is a gem.

5. Grief is Love by Marisa Renee Lee - Samantha Hoch, LPCC-S wrote a book review on this moving piece of literature and we encourage you to check out both.

6. The Seven Principles for Making Marriage Work: A Practical Guide from the Country's Foremost Relationship Expert by John Gottman and Nan Silver - is a foundational book for relationships that explores everything from how to move from conflict to connection and create lasting shared meaning in your relationship.

7. BIG by Vashti Harrison - is not small on body positivity or strength - but really big on self love. Arguably, a book for kids that we may all need despite our age as we create space for the most important love this season.

8. Love Grows Everywhere by Barry Timms - another children’s story with a powerful message. Good Reads says, “this beautiful and warmly-told story teaches us that love really does grow everywhere, in all shapes, forms, and sizes.”

9. The Body Is Not an Apology: The Power of Radical Self-Love by Sonya Renee Taylor - a favorite when it comes to body image and self-love; this book powerfully encourages its reader to push back against systemic oppressions and the impact they have on how we view ourselves. 

10. How to Be the Love You Seek: Break Cycles, Find Peace, and Heal Your Relationships by Nicole LePera - challenging readers to first look within to their own unmet needs, LePera suggests this is the key to healthy and loving connection - no matter the relationship. 

my original "why"

Trigger warning: Maternal Suicide 

by Sara Parko, LSW, PMH-C

A lot of people make assumptions about why we do the work we do. Of course a career or focus in perinatal mental health makes sense for someone who is passionate about lifting up other women and has a couple kids at home. 

But I remember how my knees buckled when I learned that a woman I respected, admired and had called a friend had taken her life.

She had recently become a mom. We had lost touch but thanks to social media and an active network of sorority sisters I had a pulse on the goings on of most of my college friends. 

The leather of the couch was cold as I fell into it, reading and re-reading the text I received. Trying to find the words to tell my boyfriend (now husband and father to my own children) that my friend had died. She had completed suicide. It felt so foreign to me at the time, something that only happens to others. And yet, for my kind and bubbly friend, life had become too much.

I am passionate about raising awareness not just about perinatal mental health but about maternal suicide rates and the noteable increased risk of suicide that birthing people face during this time of high-highs and low-lows. Suicide is the number one cause of death in the perinatal period, and it is also preventable.

Suicide during the perinatal period accounts for 20% of deaths, according to a study by Chin, Wendt, Bennett and Bhat published by the National Institue of Health in 2022. The study found that most perinatal deaths by suicide occur during the first and second trimesters as well as days 43-365 postpartum (p. 268). Social and systemic factors including younger age, marital status and/or dissatisfaction, financial stressors and race as well as comorbid mental health diagnosis increase risks for some women. “Women diagnosed with a postpartum mental disorder have a 6.2 times higher risk for self-harm compared to mothers without mental disorders. Depression is one of the most common diagnoses among perinatal patients who report suicidal ideation or who attempt or complete suicide” (p. 268). The study also noted adjustment disorders, “anxiety, bipolar disorder, schizophrenia, post-traumatic stress disorder (PTSD), and personality disorders have been associated with [perinatal] suicide attempts as well” (p. 269). Additionally, the authors found that “self-reported emotional dysregulation and poor sleep quality are associated with antenatal self-injurious thoughts and behaviors” (p. 269).  These factors are significant in the critical need to not only destigmatize mental health but also to increase support and awareness for those at most risk. 

Common prevention and intervention strategies recommended by Chin, Wendt, Bennett and Bhat and echoed by many other perinatal providers, advocates and organizations include increased detection through appropriate and consistent screenings, treatment of comorbid mental health conditions, improved access to care, and more integrated approaches to treatment through care teams. A strong case for addressing mental health stigma can also be made.

Increased awareness of these barriers to care and needed improvements are a focus area in Ohio with the Ohio Perinatal Mental Health Task Force at the helm. The task force is a  “collaborative of individuals and organizations committed to advancing policies and initiatives that continuously improve perinatal mental health access-to-care and treatment,” according to their website. The shared goal is “for Ohio to be one of the leading states in the country in perinatal mental health education and access-to-care and treatment” (Ohio Perinatal Mental Health Task Force, n.d.)

While organizations like these and practitioners like myself work hard for systemic change, there is also more we can do to empower and educate pregnant and parenting individuals in our communities. 

1. Be aware of factors that may contribute to the increased risk yourself or a loved one may experience. 

2. Never be afraid to ask if someone is experiencing thoughts of suicide or self-harm. Talking about suicide does not increase the odds of suicide or present the idea to a person. Talking about suicide is the important first step to supporting someone who needs help.

3. Educate yourself on resources available through organizations like Postpartum Support International across the globe, the National Maternal Mental Health Hotline or POEM locally in Ohio. The 988 Suicide and Crisis Lifeline is also a resource available across the country. 

I can’t imagine how low my strong, joyful and compassionate friend must have been feeling to have felt resigned to suicide. I can’t imagine what it must feel like to not be able to work through my most distressing thoughts and feelings, to not have the words to talk about my darkest thoughts and fears, or to not know where to turn for help. And I also believe she tried as best as she could.

The knot in my stomach that developed as I learned my friend had been failed by a medical system that lacks consistent screenings, appropriate follow through, and quite frankly sufficient education and awareness about maternal wellness loosens slowly with each opportunity I have to help another. To serve them. To advocate on their behalf. To educate our community and spread awareness. I doubt it will ever fully unwind, that knot, but it also keeps me going in hopes that I can offer the support that my friend so deeply needed to another mom.

She is no longer my only why; but she is the original.

To learn more about the Ohio Perinatal Task Force or to get involved visit: https://sites.google.com/poemohio.org/ohioperinatalmentalhealthtaskf/home?authuser=0

Sources:

Chin, K., Wendt, A., Bennett, I.M. et al. Suicide and Maternal Mortality. Curr Psychiatry Rep 24, 

239–275 (2022). Link

Ohio Perinatal Mental Health Task Force. (n.d.). 

https://sites.google.com/poemohio.org/ohioperinatalmentalhealthtaskf/home

what is EMDR ?

Whether you experienced long term adverse experiences as a child or a specific traumatic event as an adult, a common response is disturbing and disruptive memories that come up at the worst moments. Many clients come to trauma therapy looking for relief from these upsetting memories and the anxiety, depression, and hopelessness that accompanies them. Eye Movement Desensitization and Reprocessing (EMDR) is an evidenced-based treatment for all kinds of trauma or stressful experiences, and it focuses on these types of distressing memories. 

Francine Shapiro, PhD. was taking a walk through the woods in 1987, and just happened to notice her eyes moving back and forth across the scenery around her–and that if a distressing thought came up, she would begin to feel better the more she focused on these eye movements. She attempted to recreate this experience with clients and colleagues in her office, and EMDR was born. As the process was formalized, elements of other approaches were incorporated, such as mindfulness from Eastern philosophies and identification of negative cognitions from CBT, to formulate a manualized use of the eye movements. 

Since then, the back and forth eye movements, or bilateral stimulation, has come to be administered in many ways. Many therapists simply utilize a back and forth movement of their fingers, but it is also possible to use another object (such as a pen, or toy for children), a light bar, or telehealth platforms that display a moving shape on the screen for the client. Any sensory movement that crosses the body is considered bilateral stimulation and can include tapping, butterfly hug, drawing back and forth on a piece of paper, or even walking. 

What is trauma and does it affect the brain?

Trauma, as we’ve talked about here and here, can be thought of as any event that overcomes our normal ability to cope–but is more accurately the set of symptoms that occurs when a traumatic or stressful event does not get completely processed. 

When we experience something that overwhelms our stress response system, our natural alarm system turns off our logical brain to save all of our energy for survival, and pumps our body full of adrenaline and cortisol so that we can either run or fight to keep ourselves safe. 

That means that a traumatic event is often stored as sensory information, and without an appropriate time stamp. Instead of putting the information into a linear story that is now in the past (meaning we are safe and can relax), the brain remembers the events through the sights, sounds, smells, tastes and sensations it experienced during the trauma, and continues to believe that we are still in danger. 

How does it work

We’ve all heard that our left brain is more logical and the right brain is artistic. This is obviously a bit oversimplified, but it’s not wrong. Your left brain stores language and engages in problem-solving. It also understands linear time. The right side of the brain deals more in symbols and metaphor, and, along with the limbic system (where that alarm system is located) engages in emotions and memory making. 

Brain imaging has shown that when a traumatic event is brought to mind, the limbic system lights up, and after they receive EMDR therapy, it is the neocortex that lights up when the memory is brought up. EMDR is considered an evidence-based practice, but it is difficult to pinpoint how EMDR helps to process traumatic memories exactly. The main theory is that the bilateral stimulus helps to engage the two hemispheres in the brain in communicating with each other and integrating the poorly stored sensory information into a linear memory. EMDR can’t turn a scary memory into a happy one, but it seems to help the brain understand the event as having occurred in the past, and is now over. Meaning, that the event is not still happening and we are now safe. 

What happens in EMDR therapy? 

EMDR happens in phases. The first phase of EMDR is devoted to preparation. Your therapist will do some history taking and give you a chance to get to know each other. The therapist will then teach you regulation exercises and other tools to make sure the EMDR process feels safe and supportive. Following this, you and your therapist will identify the memories you want to target with the bilateral stimulus; and the negative cognitions, sensations, and images that relate to those targets. 

You will also choose what type of bilateral stimulus is most comfortable for you, whether it is tapping, therapist guided eye movement, or even using hand held buzzers that your therapist controls. As the therapy moves forward, your therapist will lead you in pulling the troubling memories to your focus, monitor your responses and provide guidance through processing. One way to think about EMDR is like driver’s ed. You are in the driver’s seat, but your therapist also has a wheel and a break. You’re in charge, but they’re not going to let you drive the car off the road. Just like any other therapeutic approach, EMDR requires a strong therapeutic relationship, trust and empowerment of the client. 

book review: “Untamed” by Glennon Doyle

By: Samantha Hoch, LPCC-S

Glennon Doyle is an author, podcaster, activist, and philanthropist. “Untamed” is a memoir about her life including personal growth and insight, mental health and addiction, love, family, and activism. She tells a story of finding herself through a feminist lens, sharing her journey of healing, finding love, and attaining personal freedom in a society that can tend to dictate who we should be and what we should want. 

A friend of mine recommended “Untamed” and when I first started to read it, I admit that I felt somewhat uncomfortable and annoyed. The way Doyle calls the reader to break the rules, challenge internal inconsistencies, and listen to a collection of embarrassing accounts about her put me a bit outside of my comfort zone and made me think about some things I had been avoiding. I read it a couple of chapters at a time and as I leaned into it more, I reflected on what changes I might want to make in my life to sit with the painful feelings more often, find my voice, and start living more fully and authentically. I would recommend this book to anyone who feels they may need to be challenged to grow 

Doyle was in an unhappy marriage with her ex-husband with three children when she fell in love at first sight with Abby Wambach, retired professional soccer player, speaker, author, and activist. In her book, she takes us through the emotional rollercoaster of feeling “caged” to finding her “keys,” and eventually embracing her wild spirit and being “free,” of which are the titles of the three parts of her book “Untamed.” 

Doyle opens her book with a story about taking her children to the zoo and seeing the “cheetah run.” A cheetah raised in captivity with a dog companion is trained to chase a stuffed animal tied to the back of a car. The author urges the reader to examine what it must be like for the cheetah to never have known what it is like to be wild and run free and have to be grateful for the lesser and much more limited life she has now, which is a parallel to oppression. Also in the first part of the book, Doyle discusses some of her past including struggles with eating disorders and addiction; being put in specific cultural, religious, gender, and institutional boxes; and generally feeling “caged” in her life. 

In the second part of her book, Doyle discusses how she finds the “keys” to unlocking her freedom. Doyle emphasizes the importance of sitting with all of your feelings, including those which can be quite painful. The reader gets permission to feel their pain and not be consumed by it, and further use that pain to help them become a more authentic version of themselves. Doyle also discusses how she learned how to connect with what she calls “the Knowing.”  As you read how Doyle connects with her inner spirituality and gut feelings, you begin to realize how using the mantra “be still and know” can help you let go of what you cannot control and realize that you have all of the answers if you reach deep enough within yourself. 

In the final part of the book, Doyle tells many anecdotes about her journey to being “free” and how to embrace that life is messy and unpredictable, and can also be full of love, joy, and peace. One anecdote I especially appreciated was about Doyle getting annoyed when her wife Abby comes in the room and exclaims she is so excited to join a recreational hockey team for fun. Doyle is honest in asking herself, bitterly, who has the time and money for fun? Sarcastically, she thinks, “Must be nice to have time for a thing.” Then Doyle checks herself on this and encourages the reader to do so as well. “I think we are only bitter about other people’s joy in direct proportion to our commitment to keep joy from ourselves. The more often I do things I want to do, the less bitter I am at people for doing what they want to do.” This statement really resonated with me because I think it is easy to fall into the trap of the day-to-day responsibilities and not make enough time for fun, further being upset about others in our lives who do make time for fun and playfulness. I like Doyle’s reminder to take time for ourselves and also to be happy for other people’s joy.

Starting this book, I would not have thought that I might be “caged” in some ways too. I would guess many of us like to think we are living freely and are truly “untamed.” Doyle has helped me take a closer look at how I am feeling, thinking, and acting and if it is really in alignment with my most important values, or if I might too, be “caged”. I have picked up “Untamed” again, reading certain chapters that were the most challenging, but also most rewarding, encouraging me to take a look at how I can be more present and find more joy and freedom in my own life.

april showers/may flowers: reflecting and looking ahead on perinatal mental health awareness

by: stephanie purdom, lisw-s, pmh-c

Like so many perinatal mental health professionals, I came to this space after my own experience with PMADs. Although at the time I had been a social worker myself for nearly 5 years, I had very little knowledge about perinatal mental health aside from knowing postpartum depression existed. By complete coincidence, Dr. Kat Kaeni of the Mom & Mind podcast just happened to be a guest on another podcast I was listening to, and to say I went down a rabbit hole from there is an understatement. 

After giving birth to my son and my own experience of postpartum depression and anxiety, I quickly began orienting my clinical work toward perinatal mental health. I took the Postpartum Support International 2-day certificate training less than a year after having James. I remember those two days so well–that room felt electric. The passion that practitioner’s of perinatal mental health bring to their work is so abundant, and it’s been amazing to watch how much the field–and awareness of PMADs–has grown since then.

In April, I finally sat for my certification exam. It took awhile to get around to–a move across several states, starting a business, a pandemic, and a second baby had taken priority. But, having finally taken (and passed!) this exam feels like a culmination of eye-opening learning experiences, inspiring professional collaborations, and deeply meaningful work. I feel a powerful recommitment to this field, and excitement for what the perinatal team at Wild Hope will continue to create. 

I supposed that would be enough of a reflection for April. But to be committed to the field of perinatal health necessitates the acknowledgement of the abominable health disparities between black pregnant and birthing people compared to their white peers. Black Maternal Mental Health Week was April 11-17. According to the Black Mamas Matter Alliance “Black women not only face a higher chance of developing perinatal mood disorders than white women, but they are also less likely to receive treatment due to factors such as fear of stigma, involvement of child welfare services and financial barriers.” Further, “Black women experience stress and health disadvantages because of the interaction and multiplicative effects of racism, gender, class, and age.” Additionally, the maternal death rate for Black women is 2.6x higher than for white women. The majority of maternal deaths are preventable and the higher rates for black women are often related to conditions that are not properly treated due to health inequity and medical racism. 

In addition to releasing her first book this past month, perinatal therapist, Chahdael Foreman, MSW, LSW, spoke on these issues for Black Maternal Health Week at Pregnant With Possibilities Resource Center in Maple Heights, OH. Chahdael is passionate about supporting black birthing folks and advocating on behalf of her clients, and we are proud to support her in this essential work. 

Looking ahead, May is Maternal Mental Health Month and Wild Hope is gearing up to devote the entire month to raising awareness about PMADs, those it affects, and what we can all do about it. We will continue to hold up the communities and clients most impacted by maternal mental health complications and the health disparities that exist in our culture through our social media, and through clinical work that is centered in cultural humility, inclusion, and compassion. 

We also will be supporting the annual Climb Out of The Darkness Walk, organized by our very own Sara Parko, MSW, LSW, PMH-C. Check out the Columbus Team page to see how you can help out. And on June 24, 2023 at 10 am you can catch us walking at Fancyburg Park with professionals, survivors, and loved ones to help shine a light on one of the most common complications of childbearing. In Sara’s words “You’re never alone, and we can all climb out of our darkness.” 

april is Childhood Abuse Prevention/Awareness Month: how has childhood trauma impacted you?

by: samantha hoch, lpcc-s

Content Warning: Abuse

April is National Child Abuse Awareness/Prevention Month. It is a month to bring awareness to child abuse and neglect, help recognize the signs of abuse, and prevent child abuse from happening. This month can also be an acknowledgment to all of those who have been affected by childhood trauma, but are now adults. The impacts of childhood abuse are lasting and can influence many parts of our adult lives.

Building awareness

Building awareness is important as trauma can be subjective, the power dynamic often supports the narrative of the abuser, and knowledge gaps exist regarding abuse and unhealthy dynamics in all relationships, including the relationships between adults and children. The Adverse Childhood Experiences (ACEs) scale is a tool that assesses the degree of adverse and/or traumatic experiences a person has in childhood. The scale includes several adverse experiences that we commonly consider to be traumatic, such as physical, sexual, emotional abuse, and neglect. However, there are other experiences you may not have considered that can affect mental and physical health later in life, including divorced or separated parents, adults using cruel language around the household, or having a parent with a mental illness. Studies have shown that the higher ACE score one has, the more likely they are to experience not just mental illness and substance use disorders, but physical illnesses such as cancer, heart disease and COPD as well.

According to the CDC, 61% of surveyed adults have experienced at least one ACE. Additionally, 1 in 7 children experienced some type of abuse in the past year. It is essential that we increase the awareness of widespread child abuse and its longlasting impact. While the goal of Child Abuse Awareness Month is prevention, for anyone dealing with the impact of childhood trauma the good news is that our brains are designed to heal. Thanks to neuroplasticity that lasts our lifetime, it is never too late to address past trauma.

Healing through therapy

As these adverse experiences are found within relationships, they often go on to impact our relationships later in life; oftentimes, through our attachment styles. 

• If you often fear your loved ones may leave you and need constant reassurance that they will not, you could have an ambivalent/anxious attachment style. 

• If people ever tell you that you have commitment issues, discomfort with intimacy, or “put up walls” with others, you could have an avoidant attachment style. 

• If you crave intimacy with others, but push them away when they get close to you, you could have a disorganized attachment style. 

A therapist trained in attachment theory can help you explore your relationship patterns,identify your attachment style and explore the influence on your life. While most people do not fit cleanly into a single category, being able to identify and label your unique patterns can help you to address unmet needs and develop the skills you need personally to have healthier relationships. 

A trained trauma therapist can also provide guidance in this process. Several therapeutic approaches are effective in treating concerns related to childhood trauma. To better manage and cope with feelings of depression, anxiety, or low self-esteem related to childhood trauma a therapist may utilize Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), or Cognitive Processing Therapy (CPT). These therapies are focused on a “top-down” approach that helps you learn skills to manage emotions, work on negative automatic thoughts, and be more present in your day-to-day life. For getting to the root of the pain caused by childhood abuse and to heal your origin wounds, a “bottom-up” approach can be helpful. EMDR therapy, Somatic Experiencing, yoga therapy, and art therapy are examples that help build distress tolerance with difficult memories and ease the distress they cause in daily life. Utilizing a trauma-informed approach, Wild Hope therapists will help guide you through this experience and provide the treatment that best fits your concerns and unique path forward.

It is never too late to start working on your childhood trauma. Your experiences are valid; listen to your intuition and seek support to identify what parts of you need to heal. During Childhood Abuse Awareness Month, we want to amplify that childhood trauma can show up in so many different ways in your life, that the impact can be lasting, and most importantly, support is available.

book review: "Grief is Love"

by: samantha hoch, lpcc-s

Marisa Renee Lee is a particularly engaging writer, speaker, and entrepreneur. “Grief is Love” is a book about the author’s experience of grief that is relatable and validating to any person grieving the loss of a loved one. She gives her take on grief as it relates to her own experiences of racism, sexism, and oppression. 

I picked up this book after listening to a moving interview with the author on the podcast “We Can Do Hard Things” with Glennon Doyle. I lost my father suddenly to a heart attack about a year and a half ago, so it seemed timely to read a story about grief. I had no idea how impactful this book would be for me, and now I recommend it to anyone who will listen!

When Lee was only 25 years old she lost her mother, Lisa, to breast cancer. She shares that she felt guilt and shame about expressing the feelings associated with grief, and the heavy mental and physical toll not processing her mother’s passing took on her. As an adult, Lee then lost what she calls a “very much wanted pregnancy,”and the experience of losing her mother shaped how she grieved the loss of her pregnancy later in life. 

“Grief is Love” begins by offering the reader permission to feel their grief fully and without guilt, and to say “no” to anything that does not feel in line with their unique grieving process. In chapter 2, Lee labels the vulnerability involved in grieving and the importance of feeling safe to properly experience all of the emotions that occur in this process. 

Later, in chapters 4 and 5, she provides guidance for navigating relationships in this complicated time. She encourages the reader to accept help from friends, family, and therapy–even when asking for help, or even receiving it, feels hard. Additionally, she gives words to the disappointing experience of friends and loved ones who don’t quite know how to show up for you, and the power of forgiveness and grace in these relationships.

While reading the book, I cried, laughed, and felt anger along with the author, as she effectively argues that every emotion you have related to your grief is okay and important to feel. The 8th chapter is especially helpful in this way, normalizing the confusing yet common experience of finding unexpected joyful moments while you are still grieving, and grief that pops up amidst joy.

Lee’s premise, that grief is love, reminds me of a quote I came across in my own grief journey by Jamie Anderson: “Grief, I’ve learned, is really just love. It’s all the love you want to give, but cannot. All of that unspent love gathers in the corners of your eyes, the lump in your throat, and the hollow part of your chest. Grief is just love with no place to go.” Lee tells us that the more you love someone, the stronger your grief will feel. She encourages us to continue to love those we grieve, “in the present tense.”

march reflection: hope, luck, and good old hard work

by; stephanie purdom, lisw-s

Wild Hope Therapy began for the same reasons many projects began in 2021 I imagine. After a year of lockdowns, quarantine and telehealth, I longed for community and professional connection in my work again. From the beginning, the heart of our mission was to “create a space that is collaborative, empowering and affirming of our clients as well as our team.” I didn’t just want to start a therapy practice just to start one–I wanted to bring together like-minded therapists who believed we could provide better services and live better lives outside of our jobs through a nurturing and inclusive work environment. 

The first clinician who joined me had a virtual interview, and we signed her contract on my front porch wearing masks, passing paper and pen between us at as close to 6 feet as our arms would allow. That first hire, Maggie Reinmann, LPCC-S, is now our clinical director, and I was so lucky to find her amid a pandemic. And even luckier that each therapist we’ve brought on since has been as excited and committed to our mission as we were back on that porch in Columbus. 

This month our staff reflected on why they felt lucky to do what we do here at Wild Hope. The responses, which you can see on our Instagram here, brought me back to those first days of planning out what a post-COVID therapy practice could be. The “wild hope” at the time was that we could adapt to the times, and possibly do even better work and have further reach than before, in spite of the turmoil happening in our world. And while I do feel lucky to have found this amazing team, the actual outcomes they have achieved, the clients they have reached, and the growth of the practice that would be impossible without them–well that is the result of good old hard work, resilience, and commitment to their clients and their field. Yes, I am lucky to have this team. But I am also incredibly proud.

book review: “what about us?”

By Sara Parko, LSW, PMH-C

Karen Kleiman, MSW, LCSW, Founding Director of the Postpartum Stress Center, speaker, advocate and pioneer in the maternal mental health field - is also a wonderful author and her most recent book “What About Us?” published in 2021 is the perfect resource for postpartum couples eager to safeguard their “over-anxious, over-extended, sleep-deprived relationship.”  

My family and I welcomed our second baby girl a year ago - a very sweet, little Valentine’s day gift. I’ve always been a fan of Kleiman’s work, but I picked this book up not just with my clients in mind but to support my own partnership as well. Yes, we can know “all the things” (no one really does) and still benefit from solid reminders, new skills, opportunities for reflection and encouragement towards tough, yet important, conversations in our relationships. 

“What About Us?” talks about the good, the bad and the ugly (cough cough, the most vulnerable topics) of postpartum. 

The good - We’ll start by calling out that each hard topic, while relatable, also offers prompts for reconnecting with your partner, having a hard conversation or utilizing resources to help problem-solve. “Research shows that when couples attend to the needs of their partners, both individuals report greater happiness and long-term satisfaction,” Kleiman explains (p. 2). 

The bad - okay, let’s call it the hard. “Sorry for what I said when I was feeling crappy” reads the title on page 27. Many of us may relate to the expression “hangry” – well, in pregnancy that could be hormones plus hunger and “hangry” can really put you over the edge. “Your biggest enemy right now is the lack of filter that comes with being depleted” (p. 27). Have no fear, there’s “12 tips for good communication” outlined to support you through your next relationship repair. 

The ugly - aka the stuff that makes us feel super vulnerable. From intimacy postpartum, body changes, questioning ourselves as parents and infertility and loss, “What About Us?” pulls back the covers on the experiences that are often so relatable but unfortunately not spoken aloud. So should you be wondering “What happened to my vagina?” or “Am I just like my Dad?” you’re not the only one.  

Utilizing thoughtful reflection and relatable comics this book helps to highlight our innervoice. “We should remember how good this feels the next time we get on each other’s nerves” says a woman feeling connected to her partner on page 138. Maybe you’ve thought that too, I know I have. This book also reminds us that our partnership is the center, primary, and most important relationship as we navigate through a stressful time. By focusing on our partnership, we safeguard what is most sacred and also increase our feelings of support, success and love. 

I’m a firm believer that no two postpartum experiences are the same. I’ve had two babies and I can attest to that lived experience. But, seeing on paper the thoughts and feelings that we often don’t say out loud can be so validating. Reading what may be going through the minds of our partners is so insightful and humanizing. Having a trusted guide to navigate the hard stuff during an overwhelming and “magical” time is priceless. 

Reference:

Kleiman, K. (2021). What About Us? Familius LLC.