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Do therapists also struggle with mental problems? How do they keep their mind healthy? What is maternal mental health? Are you in the “risk zone” of PPD? Interview with a therapist Abigail Burd.
If I could interview anybody I want, my top three choices of the interviewees would be a spy, a nun, and a psychotherapist.
A spy, because he dedicates his life to his country and all of its people he has never met in person. I could never do that.
A nun, because she dedicates her life to somebody modern science can’t even prove exists. I could never do that either.
And a psychotherapist, because from 9 to 5 her life belongs to very real people with very real problems, which (both people and problems) she has to leave behind the office door on her way out. I cannot even imagine how this is supposed to work.
I don’t know where one finds spies to interview nowadays. Neither would I dare to disturb a nun with my earthly business.
Whatever. A psychotherapist would have been my first choice anyway.
Normally, I wouldn’t know where to find a psychotherapist who would agree to answer my questions either. I was lucky enough not to have had the “honor” to visit one (yet).
In the post-Soviet Union society I grew up in, going to a therapist was equal to officially declaring yourself crazy.
Full Name: Abigail Burd
Occupation: Psychotherapist (Licensed Clinical Social Worker)
Hobbies: Cooking, blogging, dancing, exercising, spending time with family
Favorite Quote: “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” ~ Margaret Meade
Personal blog: BabyBirdsFarm.com
Professional blog: BurdTherapy.com
That’s why we have so many uncles and aunts who are “just bad tempered”, so many young people who “just have bad manners”, and so many families that are, in their essence, a local branch of hell.
So imagine how lucky I felt when I discovered that one of my favorite people on my favorite social network is a therapist.
Meet Abigail Burd, a psychotherapist whose normal day at work involves helping people with work issues, relationship difficulties, anxieties and mood disorders.
(Speaking about making a difference. And I used to write computer software for banks!)
Abby’s special interest, however, lies in the maternal mental health. She has two beautiful babies of her own, so she has been on the “other side” as well.
Abby is my go-to person when I have a question about babies, as we don’t have any family or friends around to help us with some advice. I can’t thank her enough for recommending us a great baby carrier that literally changed our lives.
She is also one of the few people whose advice I trust completely. Reading her blog made me realize how much knowledge she has, with how much responsibility she takes care of her children, and how serious she takes her “calling” to help others.
I’m very happy that Abby found some time in her busy schedule to answer my (as always numerous) questions.
Gill: Do therapists also struggle with mental problems? And if yes, what does it say about them as therapists? (Something I always wanted to ask)
Abby: Ha, yes! This is actually a great question. Yes, everyone struggles from time to time, and therapists tend to be more aware of emotions than the general public. So we are perhaps even more vulnerable.
On the other hand, it is even more vital for therapists to manage their own mental health needs, so that we are able to approach our clients in a healthy way.
In subtle ways, our own personal situation can interfere with how we look at someone if we aren’t aware of it. At the extreme, a therapist with unmanaged personal problems can actually cause harm.
Gill: Is there actually such thing as “self-therapy”?
Abby: Oh, absolutely! We are more knowledgeable about strategies or resources. We have more tools in our tool box. This is an advantage.
On the other hand, just because we know what to do, it doesn’t mean we do it.
Sometimes a personal therapist is like a personal trainer for mental wellness. You may know what to do at the gym, but it helps to have someone to ensure you are doing the exercises right and “spot you” when things get dicey.
Just as a trainer can have a better perspective of your posture, the outside perspective of an objective therapist helps. In addition, there are some studies that say 80% of the benefit of therapy is the relationship between the therapist and the client.
I always recommend personal therapy to the new therapists and graduate students I supervise. It makes us better therapists if we are experienced being on the “other side.”
A potential career should be evaluated in three dimensions: Do you enjoy it? Is it consistent with your values? Does it provide for the standard of living you desire?
Gill: What makes psychology and sociology so interesting for you?
Abby: I think early on I had an interest in what makes people the way they are, what influences the way they act and why they make the choices they do. I have always been fascinated by different cultures, by our similarities and differences, and sociology was a way to explore that.
Gill: Why did you decide to focus your career on mental health?
Abby: I always had an interest in psychology and majored in psychology and sociology as an undergraduate. One summer break from college, I worked as an on call counselor in residential psychiatric rehabilitation programs. I found I liked working with people. In mental health, I could both help people and feel intellectually stimulated.
A wise man once told me that a potential career should be evaluated in three dimensions:
- Do you find the every day enjoyable and pleasant?
- Is the work consistent with your values?
- Does the income provide for the standard of living you desire?
Number one and two were met. I was not under the delusion that I would get rich as a social worker, but it promised to at least be stable.
Gill: Why did you decide to do a Masters in Social Work?
Abby: I had been working for a few years as a therapist in both outpatient and residential mental health programs. I liked the work, and the only way to advance was to get a graduate degree.
In California, the options were a Doctorate in Psychology, a Master of Social Work (MSW) or a Masters in Marriage and Family Therapy.
To be honest, I made the choice for practical reasons. Although I was initially interested in becoming a psychologist, the schooling was longer and much more expensive, as the only clinical psychology programs in San Diego were private, as in, I could’ve been $100,000 in debt.
My masters was at a public university (San Diego State University), and I took night classes, so I was able to keep working the whole time. The MSW also provided the most diverse job options. In the end, I’ve come to appreciate the ecological approach of social work, which is to look at a person in their environment.
People don’t live in a bubble. Psychology focuses a little more on individuals and their inner psyche. Marriage and family therapy looks at family systems. Social workers look at all that, and consider the interaction with the social environment.
One more difference is that social workers are charged with social justice, which includes fighting for the underdog and working on a larger scale to create lasting change to improve the lives of all.
The secret to life is to find something that you would do for free and then get paid for it.
Gill: When did you decide to become a solopreneur?
Abby: Soon after my second was born, a friend of mine was getting very anxious, as she was overdue with her baby. I spoke with her over the phone around lunch time, addressing her anxiety, sharing a little advice, and helping her activate her strengths.
She ended up delivering a healthy, beautiful baby without medication or intervention before dinner. The mind is a powerful thing, and it was exciting to be a part of such a miraculous event.
I love talking about birth and empowering other women. It was so exciting to be able to help my frined. I felt a “calling” to help other women this way.
Gill: What is the best part of working for yourself?
Abby: My very first session in private practice I sat there afterwards smiling: “I just got paid to do this?” My dad used to say that the secret to life was to find something that you would do for free and then get paid for it.
Gill: You host two websites. Why not combine them so that your (future) clients also get to know you as a person?
I help people with work issues, relationship difficulties, mood disorders, anxieties, and just general “life.” It is important that they will be able to find the pertinent information that will help them evaluate whether or not I will be able to help them without getting distracted by too much of my own personal life.
To be honest, this is the first year that I am even “out of the closet,” so to speak, sharing more of my personal interests publicly.
There is the common school of thought in therapeutic circles that a therapist should be a blank slate, or at least as neutral as possible. This allows the client to benefit the most, as the sessions are all about the client, and not about the therapist.
On the other hand, moving into maternal mental health, there is a much greater overlap. Focusing my private practice in maternal mental health is my way to integrate my passion with my profession. Perhaps I will do even more in the future, but for now, it is baby steps.
80% of new moms experience “the baby blues”; as many as 1 in 5 develop clinical depression, and even more experience postpartum anxiety.
Gill: What is maternal mental health?
Abby: Maternal mental health is also sometimes called “peripartum mental health”. It includes learning to manage anxiety and alleviating depression, during pregnancy and after.
In my private practice I help with mood and anxiety disorders, pregnancy loss, processing birth trauma (post traumatic stress), adjustment to pregnancy and new parenthood, fertility and infertility concerns, deciding if/when to conceive, and partner and relationship issues.
Gill: Where does your interest for maternal mental health come from?
Abby: After having my own two babies, I was surprised to learn that the most common complication of childbirth is how it affects mental health. I thought I had prepared for everything during my first pregnancy. Yet, I was still unprepared for the challenges of the postpartum stage.
Afterwards, and during my second pregnancy, I continued to read more and learn more. I decided to pursue an unmedicated birth (which is not the norm in the United States). You can read more about “why” as well as how it turned out (besides fabulous) on my blog.
Taking our hypnobirthing class really resonated with me. All of the information related to the mind-body connection was consistent with my learning. But the results were even more powerful than I anticipated.
Personally, I know firsthand how high the highs of a great pregnancy and postpartum stage can be. I haven’t personally experienced the worst of postpartum depression, but I have an idea.
80% of new moms experience “the baby blues”; as many as 1 in 5 develop clinical depression, and even more experience postpartum anxiety. These are real, serious conditions. Fortunately, they are treatable. I know how to help, and nothing makes me happier.
Gill: What are the origins/triggers of postpartum depression?
Abby: From a biological perspective, there are massive hormone shifts happening overnight. Socially, there is what I call the “reverse cinderella effect.”
When pregnant, especially with their first child, women in my culture are doted upon. They are told how beautiful they look, and everyone goes out of their way to wait upon them.
Once the baby is born, everything is shifted to the child. They have gone from the princess to the servant. Not to mention the massive changes in every aspect of their life: severe lack of sleep, lack of exercise during the first 4-6 weeks, and body image issues.
Some Hollywood actresses lose unrealistic amounts of weight immediately after birth, but most breastfeeding mothers lose the weight in approximately the amount of time it took to put it on (9-10 months). It’s enough to make even intelligent, rational women compare themselves to hippos.
If it has been more than two weeks, and you’ve been feeling worried and unhappy for no reason, it’s time to reach out.
Gill: (laughs) I think I know that “intelligent and rational woman” you are talking about! Well, when you suddenly stop fitting even in the clothes of your husband the comparison becomes very obvious.
Is postpartum depression the same as a “normal” depression, but just caused by something specific?
Abby: (laughs) What is “normal” depression? I laugh, because there are so many different ways that clinical depression is expressed in the general adult population. The specific symptoms vary by individual, by culture, by gender.
Gill: Ok, based on this question of mine, I think we can now strike the “intelligent” part from the statement above.
Abby: Oh, that was a valid question! In some cultures, it is more socially acceptable to have physical pain and discomfort than mental distress, so depression is more likely expressed in physical complaints, such as muscle tension, stomach issues, back pain, headaches.
For others, depression is expressed as anger. This is very common in men, at least American and Mexican men (with whom I am the most familiar). They will come into therapy super angry, not realizing that depression is underlying it.
Depression during pregnancy and during the postpartum time can have just as many manifestations. Anger and irritability, anxiety and worry about the baby are common. Some women also worry about harming the baby.
Gill: Is there a way to know whether you are in the “risk zone” for postpartum depressions? A checklist, a test one could take?
Abby: Generally, if it has been more than two weeks, and you’ve been feeling worried and unhappy for no reason more often than not, unable to look at things from a positive perspective, it’s time to reach out.
If you follow the link in this post of mine, you can take a ten question quiz. It’s called the “Edinburgh Postnatal Depression Scale” and has predictive validity during pregnancy and up to one year postpartum.
Gill: Are there any preventive measures to reduce the risk of postpartum depression?
Abby: The basic idea is not to be left alone with your negative thoughts. The general advice is the same as for any person in an overwhelming situation: educate yourself, talk to others who are experiencing the same things, and consult with professionals.
Forgive me for linking to another of my posts, but this one on “7 Ways to Find a Circle of Support When Pregnant and Postpartum” offers suggestion to help reduce the risk of PPD.
Seeing people get better is the true “payment” and the greatest reward of my field.
Gill: What case in your career left the biggest impact on you?
Abby: The most basic foundation of therapy is trust that what is said in counseling stays in counseling. Therapists are required by law to go to great lengths to protect the identity of our clients as well as their private health information. Not even disguised information can be shared publicly.
What I can tell you is that I have had a number of clients that made tremendous gains. I still think about them. Seeing people get better is the true “payment” and the greatest reward of my field.
Gill: I had no idea it’s so confidential! I guess therapists are a bit like spies. They, too, can use the phrase “If I tell you I’ll have to kill you” (laughs)
How do you cope with the emotional load that comes your way from other people with sometimes very serious and very sad issues?
Abby: After I am sure that I have done absolutely everything I can, including consulting with other therapists if needed, there comes a time when I have to leave work at work. This is something that has to be practiced by most people who are drawn to the helping professions.
We have to use our self-care and sometimes distraction. After one very extreme event, I attended a Native American sweatlodge. It was very helpful in moving on.
Gill: Is this a bigger challenge of being a therapist?
Abby: Absolutely. We have to learn to separate our feelings from the feelings of our clients’. We learn about transference and countertransference.
Gill: Thank you so much, Abby, for speaking to me today. I think I picked your brain enough already. One last question: What are your tips to keep one’s mind “healthy”?
Abby: One tip is to do one thing once a day that you do really well, one thing that you can do with “mastery”. Everyone has at least one talent. You will feel better about yourself doing something well. Especially if you are struggling with other things that are challenging.
Another thing I love is the acronym GRAPES. Try to do things daily that give you:
Gentleness: Allow yourself to be gentle with yourself and your expectations.
Relaxation: Do at least one thing relaxing.
Accomplishment: Similar to doing something with mastery, do something that makes you feel good about your abilities. Or just cross one thing of your to-do list.
Pleasure: Do something that brings you pleasure.
Exercise: Do 60 minutes of cardio exercise at least three times a week, which can be as effective as an antidepressant medication in lowering depression and anxiety.
Social: Interact with positive people, preferably in real life.
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