In a Washington Post article written on March 3, 2018, three reproductive psychiatrists discuss the importance or considering Mom’s emotional and physical needs and unique circumstances when deciding if breastfeeding is the best decision for her and her baby.

Far too many women that I have seen in my practice experience undue guilt should they come to the conclusion that they will not breastfeed their babies. 

Breast is not always best when a new Mom’s mental or physical health is compromised. There is no right or wrong way; rather the decision that a Mom makes will be the best decision for her and her baby. 




On Parenting

Doctor says: When it comes to breastfeeding, your health and happiness matter as much as your baby’s

By Vivien K. Burt, Sonya Rasminsky and Robin Berman March 3, 201

Whoever said, “Don’t cry over spilled milk” couldn’t possibly have been talking about breast milk. As reproductive psychiatrists who specialize in treating women who suffer from depression and anxiety during pregnancy and the postpartum, we see far too many tearful new mothers for whom breastfeeding is a source of self-recrimination.

Doggedly determined to provide breast milk exclusively for their babies, these moms endure breast and nipple pain, around the clock pumping, sleep deprivation, anxiety, and chronic feelings of inadequacy—all for the sake of doing what’s “best” for their babies. As physicians, we think we know better, but as mothers, we too bought into the dogma that breast is best at all costs. We would never have taken our own advice:when it comes to breastfeeding, your health and happiness matter as much as your baby’s.

Sheepishly we recently shared our secret stories of shame with one another:

“I proudly accumulated a freezerful of stored breast milk by routinely pumping immediately after nursing. I was happy that my baby never had to have formula, and I was devastated when I had to throw away gallons of expired milk. To this day, I have deep regret about my choices. I wish that I had never bought the pump; my time would have been better spent bonding with my baby.”

“When I went back to work when my baby was five months old, I was so ashamed that I had switched to formula, I lied to all my friends and coworkers.”

“For me, nursing was harder than medical school. My milk was slow to come in and my baby howled whenever I put him to the breast. It hurt so much that I cried. I was so determined to feed him breast milk that I didn’t realize that he was getting dehydrated. Even when he was hospitalized with an IV, I felt that my most important task was to try to pump milk for him. In retrospect, I wish that I had transitioned to formula—we both would have been happier.”

Sharing these stories, we wished that we had put less pressure on ourselves. Despite our knowledge about the importance of maternal mental well-being to healthy mother-baby bonding, we let shame and guilt eclipse our good sense.

[Maternal depression: If there’s no mama, there’s no baby] 

The potential benefits of breast feeding are extensive and well-documented: decreased rates of infection, diabetes, leukemia, obesity, increased IQ scores; more rapid weight loss in nursing mothers; decreased rates of breast and ovarian cancer in women who nursed. But these statistics do not tell the whole story. Most benefits are small in absolute numbers, and do not take into account unique maternal and family issues that make up the reality of new parenthood.

Like the mythological giant Procrustes, who captured hapless travelers and cruelly adjusted their bodies to fit his bed despite their differences in size, the health care system has colluded to ignore the individual circumstances of mothers in order to promote a one-size fits all prescription: breast milk-only nutrition for infants. The American Academy of Pediatrics recommends that infants be exclusively breast fed for the first six months of life, followed by continued breast feeding “for one year or longer as mutually desired by mother and infant.” The American College of Obstetricians and Gynecologists emphatically seconds these recommendations and has charged its members “to encourage and enable as many women as possible to breastfeed and to help them continue as long as possible.” Neither body addresses the individual needs and circumstances of new mothers; neither allows for the possibility of overwhelming physical or psychological challenges. Let’s not forget that the mother-baby bond is comprised of healthy mothers and babies and we can’t overlook that half of the equation.

These recommendations were put in place with a public health motive in mind: to increase the number of women breastfeeding in the United States. Breastfeeding often requires time and patience, and lactation consultants can be helpful to make the experience work in a meaningful and gratifying way. However, thinking only about the benefits for the baby, one could easily come to the conclusion that it’s worth going to any length to provide baby with breast milk. From a very early age, babies respond to what they experience. It’s important to remember that breastfeeding involves far more than just nutrition; it’s also about holding, cuddling and emotionally connecting with baby in a way that facilitates the development of a secure, bright, and engaged child. And this may be accomplished in ways that do not involve exclusively breastfeeding.

The professional guidelines are based on good science. But for many new mothers, the recommendations carry the force of a threat: if I don’t breastfeed, my child is more likely to get sick; if I don’t breastfeed, my child won’t be as smart; if I don’t breastfeed, I’m not a good mother.

Here’s what not enough people talk about: just as new babies are vulnerable, so are their mothers. And a mother’s mental health is crucial—not just to her, but also to her baby. A depressed and anxious mother isn’t able to provide the nurturing that her baby needs to develop and grow. And if that depression and anxiety is caused or worsened by the breastfeeding experience, breastfeeding isn’t worth it.

Breastfeeding can be a wonderful way to bond with a baby, but it’s not the only way.

It certainly is not synonymous with good mothering. A good mother? One who is calm, well-rested, and emotionally engaged with her baby in whatever way works.  She nurtures her own mental health, and is free to determine what works for her and her family. She’s the one most likely to provide what her baby needs to be soothed, calm, content and healthy.

We all know not to throw baby out with the bath water – but let’s not throw mother out for her milk either. Here’s our prescription: If breastfeeding works for you, great. If it doesn’t, don’t tie yourself in knots to make it happen. Under some circumstances, formula (alone or as a supplement to breast milk) can be the better choice. And sometimes it just might make sense to dump the pump.

About the Authors:

Vivien K. Burt, MD, PhD is a professor emeritus of psychiatry at University of California, Los Angeles and the co-director of the Women’s Life Center at the Resnick Neuropsychiatric Hospital at UCLA.

Sonya Rasminsky, MD is an associate clinical professor of psychiatry at University of California, Irvine. She has a private practice in Newport Beach, Calif.

Robin Berman, MD is an associate professor of psychiatry at UCLA and the author of Permission to Parent

Do You Wonder If You Are In An Emotionally Abusive Relationship?

Now, more than ever, I feel the importance of addressing the issue of emotional abuse in relationships, sometimes referred to as psychological abuse.

Why? Because, given the current social climate where bullying, demeaning and abusive behavior have been emboldened, there is a significant increase in the distress that I am hearing in my patient's experiences.

They are more likely at this time to either remember past incidents of emotional abuse or have become more aware that their partner’s behavior may be emotionally abusive.

The light that has been shone on emotional abuse enforces the notion that degradation, intimidation, manipulation of others should never be normalized or tolerated.

I have met with countless individuals over the years that painfully assume responsibility for being treated poorly in a relationship, unaware that what they are experiencing is emotional abuse.

Anna came to therapy three months after the birth of her child realizing she did not want her husband to treat her daughter the way he had been treating her.

In our first session together she described how he was disrespectful, frequently angry, swearing and name -calling. Yet, she rationalized his behavior. She felt like it was her fault.

She walked on eggshells, afraid of making a mistake, feeling as if she could not do anything right. She claimed he attempted to distance her from her family and friends. After incidents of emotionally raging at her, her husband would apologize and be repentant, only to repeat his behavior again. These episodes were confusing and contributed to Anna questioning her reality of what had occurred. Was it really as bad as she thought?

Rachael sought therapy due to having problems in her relationship with her boyfriend. She described him as being moody and angry when things didn’t go his way and constantly critical of her. As a result, Rachael was anxious all of the time.  ‘What am I doing wrong? Should I just accept his behavior? What can I do?”

Both Anna and Rachael struggled with self-doubt, blame and anxiety. What could they do to change their partner’s behavior, they wondered?

You are never responsible for the abusive behavior of your partner.

Simply stated, emotional abuse is when your partner attempts to control you through verbal assaults, intimidation, humiliation, and manipulative and belittling behaviors.

Having a safe place to share their thoughts and feelings, both Anna and Rachael were enabled to gain strength and self-assurance to trust their emotional experience in order to take measures to protect and care for themselves.

Following are some of the signs of emotional abuse:

-       Humiliating and shaming you, making fun of you in front of others

-       Frequently criticizing you

-       Name calling, yelling, swearing

-       Making everything your fault and not taking any responsibility

-       Controlling who you see, where you go

-       Isolating you from family and friends

-       Controlling you with money

-       Threats and intimidation

-       Manipulation and lying

-       Being told your feelings are wrong and ridiculing you

-       Belittling your appearance, your ideas, your accomplishments

-       Gaslighting – an extreme tactic used by your partner to gain more power and cause you to question your own judgment and reality of facts and events, i.e. “ I never said that,” or “ That did not happen."

Emotional abuse is insidious in that it erodes your self-esteem, sense of safety and has the effect of causing you to believe that you are responsible for the mistreatment you are receiving. 

You are never to blame. You deserve to be treated with love and respect.

You may find yourself feeling anxious much of the time and/or emotionally numb.

Perhaps you feel unsure and confused about the relationship and are fearful of your partner’s reaction in response to you differing with them, or confronting them about how they are behaving.

You may feel as if you cannot do anything right.

Your partner is extremely critical and over time you begin to believe you are a bad person, that you are constantly doing something wrong.

Depression can set in as you struggle to wonder how someone who says they love you can treat you so poorly.

  Therapy can be helpful in supporting you in your wish to feel strong again.

1. It is so valuable to know you are not alone in this. You do not have to figure this out by yourself.

It will feel like a weight has been lifted when you receive validation for your experience. It is the beginning of taking care of yourself and trusting your instincts.

2. Therapy will support and guide you in listening and paying attention to your instincts.

To identify your heartfelt emotions underlying the anxiety and/or self-doubt that you have been living with will then give you direction and clarity. Making decisions in your best interests will come more easily.

3. A safety plan is essential to ensure that you can protect yourself and family if needed and a therapist can assist in developing that.

4. You will learn how to set limits and maintain healthy boundaries.

5. It will become apparent to you that behavior you might have been rationalizing, you no longer have to accept.

6. Addressing the issues surrounding emotional abuse is a process and takes time. A supportive therapy will respect your pace and need to go slowly in reaching your goals.

Taking the first step to speak to a trained professional is a courageous act and will provide much needed relief and direction.


*The case studies are an amalgamation of several clients. All identifying information has been changed or removed so as not to divulge the identity of any client, while still retaining the pertinence of the issues.


Grieving Is As Distinctive As Your Fingerprint - 10 Things I Know To Be True About Grieving

Recently I met with a patient of mine who tragically lost a family member and is in the midst of his grieving. Having never experienced a significant loss before, he is feeling a bit out of control, like a kite flying in the wind. He feels side swiped by emotions that seem to come without warning. He has a sense of being lost, worrying about what his future will look like without his loved one by his side. And he wonders if how he is grieving is normal.

A second patient wondered when she would feel like herself again after losing her newborn at term. Having had a healthy pregnancy, this loss was devastating and unimaginable. Self-blame and feelings of inadequacy weighed heavily on her.  Was there something she could have done differently? How would she ever get through this?

Both of these individuals and countless others, after a loss, feel disoriented as they find themselves in unfamiliar territory.  They wonder how long they will feel this badly, if they are going about this in the correct way. And they consider whether they are weak because they cannot seem to “get over” their sadness and grief in the time that they believe others feel they should.

No rules. No right or wrong way to grieve. No time limit.

I am writing this blog primarily to let you know that you are never alone and to tell you to be kind to yourself as you go along in your healing.

Accept where you are today in your grieving process without expectations of where you should be.


Having experienced many significant losses and counseling others going through this process, I can honestly say that no two losses are the same.

When I learned of my dear friend’s accidental death many years ago I felt as if I had lost my right arm.

When my Dad passed away, my heart hurt.  I not only grieved in the present but also grieved for losses long ago. 

A few years later my Mother passed away.  I felt numb for sometime. I was busied by having to take care of her affairs. It wasn’t until months later that my grief came in waves, at moments I could not have predicted. 

And in the recent past, when my best friend of over 30 years passed away, I experienced deep sadness, a mixture of emotions, wishing I could have done more.

I continue to miss each one of these special individuals.  Moments will cause me to stop and remember times we spent together, bringing up joy as well as sadness and tears. But I am sustained by the memories that warm my heart and make me smile.

It wasn’t always an easy journey. However, I knew with time my heart would heal.

This is what I learned along the way. This is what I know to be true about grieving. 

1.     There is no right or wrong way to grieve.

You shouldn’t expect yourself to “be over it already,” or not feel sad.  Even though the rest of the world goes on with their lives, you remain in the midst of your loss. Be patient with yourself and know that whatever you are experiencing on any given day is a normal response to a deep loss.

2.     Grieving does not mean you are weak.

Grieving openly and privately is a normal and healthy response to losing a loved one. You’ve all heard the saying that speaks to the deeper your love and attachment, the deeper your loss. To feel great loss means you have felt great love.

3.     The relationship you have had with your loved one will determine how your mind, heart and body grieves.

No two losses are the same. Some are complicated. Sometimes grieving is delayed.

4.     There is no time limit to your grief.

Don’t let other’s expectations dictate how you should feel at any given time. Take all the time you need.

5.     Grieving is akin to riding the waves.

As you move along, you will have better days. You will also be struck with waves of grief when you least expect it. The periods of calm and a sense of normalcy will come and the waves will eventually present themselves less often.

6.    It hurts like hell and at times can bring you to your knees. But it won’t feel that way forever.

7.     Allowing yourself to experience your emotions will ease the pain.

 Holding your emotions in will prolong your grieving.

8.     Being surrounded by supportive friends and family is imperative.

Many people are uncomfortable with loss. They may say things that although well-intended are not always helpful. Know who the people are that understand loss and can just be with you without expectation.

9.     Sometimes distractions are chosen to cope with a loss.

Special attention to self -care and maintaining your health will aid in your ability to weather this storm.

If you find yourself using alcohol, drugs or other unhealthy diversions, you may want to seek professional counseling to help support and provide you with beneficial suggestions to help you manage your grief more comfortably.

Counseling and/or a grief support group can also provide a warm and caring environment in which you can express yourself freely and not feel isolated in your grief.

10. There is light at the end of this journey of grieving.

You will not always feel as sad and in despair as when your loss first occurred.  You will begin to let your shared memories of your loved one carry you forward.

There is no reason to shoulder your grief alone. Whether you are struggling with coping with your grief or simply know that it would be helpful to have someone walk alongside you, seek support from a reliable person or an experienced therapist.

Honor yourself and your experience. You matter right now.  Care for yourself in ways that are comforting.

With time, nurturing of yourself and support, you will find joy and contentment again in your everyday life.








4 Ways In Which Your Emotions Are Your Guide

Matt thought he was experiencing a resurgence of his depression. He wondered whether he needed to adjust his medications. For two weeks, he noticed he had little motivation during the day, wanted to isolate, watch movies on TV and do the minimum at work. After careful assessment, it was clear that he was not experiencing a major depressive episode. So why was he feeling so lethargic?

As we continued on in our conversation Matt began to talk about a concern related to a coworker that was on his mind. The more he spoke about it, the angrier he realized he was. After sharing and experiencing how he was feeling, he was able to determine how he wanted to handle the situation and was surprised at how much better he felt.

We laughed as he looked at me and said “It’s those darn feelings again!” 

In our work together over the last year, it had become clear that Matt learned early on to detach from his own emotional experience. In his family, his expression of emotion was met with anger, dismissal and he was told he was too sensitive. He internalized that it was not emotionally safe to share what he was feeling. In his adult life, he experienced anxiety and lethargy, which unbeknownst to him were indicators of core emotions that he had learned to distance from. With time, in our work together, Matt was able to identify and experience a range of emotions. His anxiety decreased, his energy level improved and his relationship with himself and others felt more authentic.

Your emotions are your compass.

Lack of awareness of one’s emotions is often a learned adaptation to messages one has received early in life.

So how do we lose our direction and learn to detach from our emotional selves? Our earliest and significant relationships have a profound impact on how we navigate our world. We receive direct or indirect messages about what is acceptable to feel and to express.

You might have experienced walking on eggshells around others unpredictable moods and learned to appease others, having to suppress your own worry and distress. Or you could have been shamed for crying and not being able to “pull yourself together.” In these and other scenarios, you develop adaptive ways to survive and make the most of your situation. You learn to suppress your feelings and internalize that what you are experiencing is selfish, wrong or shameful. You eventually lose touch with your emotions and become detached from your internal emotional experience. You aren’t aware that you are suppressing what you feel.

Rather, you are responding to your environment and doing the best that you can.

Those adaptations are helpful for you at the time. Later in life, you continue to respond in the same protective way, as that has become your template. Those defenses, which help you to avoid your feelings, are no longer needed and rather than being adaptive, no longer serve you well.

Let’s look at how your core emotions are your best guide. Remember, a compass gives you direction and helps you get your bearings.

1.      Your core emotions such as fear, anger, disgust, joy and pleasure are your compass. They guide and inform you on how to best take care of yourself. They tell you what you might need. They create a path to resolving dilemmas you are facing. They help you to connect with others and have more meaningful relationships.

2.     Identifying your emotions gives you choices. Yes, that’s right, choices.  Choices to ride the waves for a while, choices to address a bothersome situation, choices in how you want to live your life.

3.     A key to identifying your emotions is that they are manifested physically. For instance when you have to speak publicly, you may become anxious.  If you can tune into where in your body you are feeling the anxiety, you can probe further. What is the anxious feeling telling me? What emotions are underlying my anxiety? How do I want to be able to move through it?

4.     Being aware of your emotional experience and spending time in that space gives you autonomy and direction. No one knows better what is best for you than you. For example, rather than not wanting to rock the boat and take a stance of “It doesn’t matter what we do,” you open yourself up to options and pleasurable experiences.

Emotional experiences become less frightening when you are able to identify and express them.


Try experimenting next time you are anxious or unable to identify what you are feeling.

Slow down.

Take a few deep breaths; notice where you might be experiencing tension in your body and ask yourself what emotions might be underlying the physical sensation. You might be surprised to get in touch with some emotions that can then clarify a situation for you.

Knowing and experiencing what you are feeling is the first step.

I would love to hear how the experimenting goes for you. If you have comments or questions, please feel free to email me at


*This case study is an amalgamation of several clients. All identifying information has been changed or removed so as not to divulge the identity of any client, while still retaining the pertinence of the issues.







Dating To Fill The Void In Your 20's And 30's - Is That The Solution?


We live in a world of couples. And if you are in your late 20’s or 30’s it seems everyone around you is either in a relationship or getting married.


There is the societal and internal pressure to get out there and find someone. And if you don’t meet that special person, with all of the dating sites that are available, then you start to wonder, ”What’s wrong with me,” rather than “It will happen when it’s meant to be,” (sage advice from a Baby Boomer).

Your focus can become an obsession to meet and find the perfect match. You are on Tinder and JDate and and sundry other sites. You are so busy checking your phone and computer to see if you get a click, that little time is left to live your life. It can become a vicious cycle as rejection is easily felt if you aren’t getting enough traffic or you go on dates that are “just fine.”

You lose touch with who you are and what you enjoy because you are so focused on finding your soul mate or easing your sense of loss.

Sheena Sharma wrote a clarifying article on how the importance of having time with yourself after a relationship breakup is an opportunity for growth and self-reflection. 

Read Article Here

So often I will meet with individuals who struggle with defining their sense of worth based on being in a relationship and on what others think about them. After a date they are wondering how the other person felt about them with far less importance placed on their own reactions.

The solution lies in you getting to know yourself.

Rather than filling the void of not being in a relationship with distractions that may not be serving you well, enjoy your alone time.  

You will gain clarity on what brings you pleasure and what you value in your life.

Here are some ideas to help you navigate this time.

·      Spend quality time with friends and family. Having a community and a support system are integral to you sense of well being.

·      Try new experiences. Explore different interests. Take a class, dive into a hobby that you have been putting off, learn something new. Be active

·      Take good care of yourself. Eat healthy and exercise.

·      Reflect on what is most important to you, what brings you joy as well as gain clarity on how you most like to spend your free time.

     Journaling is often helpful as a way to sort out how you are feeling, see patterns, learn where you may be stuck and gain perspective.

·      If you find yourself continuing to struggle, despite your best efforts, consider speaking with a therapist. Individual counseling can provide a safe and supportive place to share your thoughts and feelings, find solutions to the problems you are experiencing and see that there is light at the end of the tunnel.

It is with time and attention to yourself that you become most comfortable in your own skin. Learning and doing what you love and being at ease with allowing your emotions to guide you will enhance your self- confidence. You will bring a better self to any relationship down the road.



Considering EMDR Therapy?

“Can You Benefit From EMDR Therapy?” is an article written by Francine Shapiro, PhD the originator of EMDR.

Francine Shapiro’s article and her book, “Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy” provides a straightforward guide to further understanding the theory behind EMDR as well as identifying the myriad life circumstances in which EMDR can be beneficial.

Read Article Here

Since 2003 I have utilized EMDR therapy as part of an integrative approach in my work with patients.  

I and my patients continue to be astonished at the depth at which healing from symptoms of emotional distress that are the result of disturbing life events occur.  


It is always within the context of the therapeutic relationship that a decision is made to incorporate EMDR into our work together.  If it is determined that EMDR can facilitate alleviation of your symptoms and distress, we will review the philosophy behind EMDR, discuss the protocol as well as how you might benefit. I also refer patients to and as resources to learn more about EMDR therapy.

The most essential consideration is that your past experiences do not have to continue to cause upsetting symptoms in the here and now.

If, for example, you find yourself dealing with recurrent anxiety, reacting to situations in disproportionate ways, are troubled by memories of past events or just feel stuck in repetitive patterns, it could be useful to explore EMDR therapy as an effective treatment.

To learn more about how I utilize EMDR Therapy into my work with patients, please view the EMDR Therapy page on my website.

Navigating Life Transitions

When experiencing life transitions, we cannot always anticipate how we will feel or what the road ahead holds for us. Yet, when one chapter of your life comes to a close it can be an exceptional time of rediscovery, a time to redefine who you are and what you would you would like the next chapter of your life to look like.


Major life transitions such as going off to college, changing jobs, getting married and retirement are all significant turning points in our lives. And despite the fact that these transitions have been planned for with enthusiasm you can find yourself surprised by unexpected emotions and feeling as if you have lost your footing. And then there are the transitions that could not have been predicted such as receiving a serious medical diagnosis or the sudden loss of a loved one.

Transitions are about endings and new beginnings.

We don’t often think about it this way but all transitions require letting go of one chapter of your life and entering a new one. When you are going through these times, it is normal to experience a sense of being overwhelmed, lost, and perhaps worried about what the future may look like.

Transitions are also opportunities for self-reflection and growth.

Common threads weave themselves through all significant life transitions.  Knowing what to expect emotionally can help normalize the experience of feeling confused and unsure of what is next. It is a beginning roadmap to navigating the changes that you are facing.

Following are typical experiences that accompany major life transitions whether planned or unexpected.

  •  Feelings of loss and grief.

When we think of loss, we think of the passing of people we love. But loss shows up in many other ways.

Loss is experienced when we leave a situation or are being left. Loss occurs when we come upon milestones in our lives such as getting married, having children, and aging. And loss comes from expectations not being realized.

When going through a major transition you can experience sadness even when the changes have been planned for.

Ron who has had a medical practice for over 30 years was experiencing a dramatic decrease in business. The landscape of how patients were referred had changed. He didn’t know what to do, felt hopeless, depressed and panicked about his future. When framed as a grieving process, he said that he never thought about it in that way.

Heidi, a new Mom found herself struggling in the first several months after having a baby. “Why didn’t anyone tell me it was going to be this hard?” She was an active, professional woman and her life changed in ways she just could not have imagined. She struggled with her time not being her own.

Tess, a recently widowed woman described feeling “rudderless” after her spouse passed away after a long illness.

Most of us are planners. We like to prepare for what is ahead. Knowing and anticipating that this is a normative time of grief and loss allows us to more easily accept whatever emotions surface during this time. Your emotions will guide you in your changes. Allowing the grieving to occur opens doors to helping you make the necessary adjustments that will aid you in moving forward

  • Your sense of identity is shifting.

Don’t we have the tendency to define ourselves in part by what we are doing or roles we have taken on?

Graduating college and joining the workforce causes shifts in how you view yourself.  Having a child and becoming a parent dramatically changes your sense of identity. We identify strongly with the labels we attach to ourselves.

When you move into a new time of your life, your sense of yourself is evolving. You are growing. And at the same time it can feel disorienting. Again, this is a normal experience of going through a transition.

Mary retired after a long teaching career. Finding herself for the first time in many years without the structure of work, she felt lost and without direction. She planned for this time but nevertheless, it was a challenging transition.  With self-reflection and time, she was able to enjoy her free time, something she rarely allowed herself in the past. Once more comfortable with her new surroundings, her path forward became clearer.

Becoming a Mom was something that Kim always looked forward to. She didn’t expect the weeks and months following the birth of her daughter to feel so unfamiliar. Her belief was that becoming a parent would feel so natural.

It takes time to feel comfortable with yourself in your new situation. Our sense of ourselves is continuously transforming as we approach new stages in our lives. It is often a time when we review our past, clarifying what we want to take with us and what we want to leave behind.

  •   Transitions are wonderful times of growth.

They are turning points, opportunities for us to rediscover, redefine who we are and how we want to live our lives.

It is a time for self-exploration. How have you handled change and transitions in the past? Reviewing this can give you clues to how you are negotiating the changes now. Once we understand ourselves more clearly, more choices and possibilities become apparent.

What do you want your life to look like going forward? What changes do you want to make? What areas of your life do you value and want to enhance?

Jay as a newly married man wanted to change patterns of relationships that he learned growing up.  Ann, after her children left home, realized she wanted to incorporate more fun in her life, pursue some hobbies that she hadn’t had time for, realizing that perhaps she had neglected herself.

Experiencing feelings of loss, shifts in your sense of identity and experiencing many unexpected emotions are all part of what makes going through major transitions in your life challenging. Getting support from family and friends, talking with others who have gone through similar situations can provide you with perspective and reassurance going forward.

Many individuals seek support through counseling at turning points in their lives when they feel lost and the changes feel unmanageable. Normalizing one’s experience and having a roadmap for going forward has been invaluable in helping to navigate many transitions.

Taking time to reflect, honoring your experience and exploring opportunities will pave the way to living your life with a sense of purpose and ease. With patience and taking time to settle in, you can expect that you will emerge with fresh ideas and more confidence as your sense of self and identity continue to evolve

Couples Counseling Before Marriage – Best Relationship Advice

 Couples Counseling Before Marriage – Best Relationship Advice - Denver, CO

"Everything You Need To Know About Premarital Counseling," written by Sharon Nayler for the Huffington Post is a well written, comprehensive article on the advantages of premarital counseling.

Read The Article Here

Early attention to significant issues in your relationship and intervening preventively are keys to a healthy relationship and a supportive and loving marriage. 

Typically, more time is spent planning for the wedding day than for the days and years ahead. Doesn’t your relationship and upcoming marriage deserve the same if not more attention? 

Couples and marriage therapy are often seen as a last resort when conflict arises or a relationship is in crisis.  

Seeking premarital counseling preventively and with the intention to build a strong relational foundation going forward will support your ability to handle whatever challenges come your way.

In my psychotherapy practice, I meet with couples at varied stages of their relationship. 

Early on, couples wanting to strengthen their commitment will come to therapy either to resolve areas where they may feel stuck, to address and determine if they can sort out anticipated roadblocks or simply to find productive ways to communicate about concerns that may arise.  Others will seek assistance later in the relationship when unhealthy patterns are being repeated, problems have established roots or a challenging life event has occurred. Solutions can be found and change can occur at every stage of a relationship.

But why not make the commitment to talk about your hopes and wishes for your future before saying “I do?”

Premarital therapy offers rich opportunities to address any concerns that either partner is having and to develop healthy communication that promotes respectful listening, understanding and compassion for one another.

To learn more about my philosophy of treatment and therapeutic approach when providing Couples/Marriage counseling, please view the Couples Counseling page on my website.

Helping A Loved One With Depression


Helping A Loved One With Depression

Have you ever wondered what it feels like to be depressed, to try to function when everything feels like an effort?  Most people don’t often think about it.  Why would you? It’s a “depressing” issue to consider and it is hard to imagine.

One patient described it this way, wishing a loved one “got it.”

“My eyes are heavy, I’m crying a lot and have so little energy. It is an effort to get myself up and take a walk. But I look great! That’s what you tell me. You don’t understand why I might be irritable or disinterested in getting out and doing things. Sometimes you tell me I’m difficult or you get frustrated with me. You think I should be able to clean my house or join you for dinner. I go to work but I am doing the minimal and getting by. I try to do things to feel better but those things don’t always work. And then I start to spiral into all of these negative thoughts. That’s when I know it is really bad.  I’m truly doing the best I can. I just wish you wouldn’t judge me."

The truth is that depression is still hard to talk about. People often don’t understand what it is or how to be helpful.

You can’t always know when someone is depressed because you can’t always see it.  For the most part, we find it easier to support someone if they have a cast on their arm, or have recently had a surgery. We know how to be there in those circumstances: ”How can I help you?” “What do you need?” “I’ll bring over some food.” “Do you want company?” “Do you need a ride to an appointment?”

Depression is not a person’s fault. They did not bring it upon themselves. Rather, depression is a medical condition that affects an individual physically, emotionally and behaviorally. The good news is that depression can be treated successfully.

Following are four suggestions for supporting your friend or family member who may suffer from depression.

  • Learn about the symptoms of depression. Educate yourself through reliable sources. 




  • Support them in getting medical and psychological care.

Often individuals with depression are unaware that depression is what they are dealing with. It may be a situation where they have felt this way before and feel they can change things by sheer willpower. Or they may be embarrassed and believe they should be able to handle it on their own. Depression is different than having a bad day or a bout of the blues. 

If your friend or family member is not already getting professional help and guidance, support them is doing so. Depression requires medical care. Meeting with their primary care physician or a mental health professional is a good first step in evaluating and resolving their symptoms.

  • Be empathic . Try to put yourself in their shoes. Ask them what it is like and how you can be helpful. Don’t judge them. “I can only imagine how difficult this feels for you right now.”  Let them know that you care and are there for them. Individuals suffering from severe depression often struggle with feelings of worthlessness and low self-esteem. Talking about their symptoms with them if they choose will reduce the stigma and shame that they may be feeling.


  • Check in on your friend or loved one frequently. 

People who are depressed tend to isolate and withdraw. They often feel that they are a burden to others.  Engage them in activities that they find pleasurable. Going for a walk, cooking a meal together, completing small tasks can bring a sense of satisfaction.  Or just spending time together in whatever way is comfortable for them can be uplifting and reassuring. 

Receiving care from a trained professional is key in resolving symptoms and helping your friend or family member to resume their lives in a meaningful way.

But your support through encouragement, understanding and friendship are significant factors in helping your loved one return to health.