What Emotions Does My Baby Feel?

Often times, new parents worry about their infants social and emotional development. Some will say “She has always been a happy baby” or “He is so shy”. When an infant is born, their capacity to express emotions is likely biologically based. They are responding to basic survival needs and trying to get those met. However, soon after birth, infants start to develop in their capacity to share their emotions. Within months, an infant can engage others in interaction, convey sadness, anger, and delight. Infants also gain the ability to use the emotional expression of their caregivers to determine how to respond to their environment. Based on this connection, you can understand why it is so important that caregivers assess their own mental health. Not only does that biologically impact infants through neurons but it also impacts them socioemotionally through assessing how to react to stressors, how to process environmental surroundings, and how to cope.

By the time your baby is a toddler, they typically have developed self-awareness, empathy, and self-conscious feelings like shame or embarrassment. How these feelings are developed, as well as emotional capacity of caregivers, greatly affects the child’s emotional development. Which can have a lasting impact into adulthood. Creating habits that can last for generations. Having a nurturing environment with developmentally appropriate responses to stressors, environmental ques, etc, can increase positive outcomes for attachment and bonding.

If you need help in maintaining, developing, or returning to socioemotional competence with yourself or your child reach out. Schedule your first appointment today by emailing, calling, or texting me. Visit my Contact page for more info. Also, sign up for my series, More Than Just the Nursery ™. Remember, you are not alone, and you are not to blame.

Traci Schank, LCSW

Traci Schank, LCSW Counseling

Hello! My name is Traci Schank. I am a Licensed Clinical Social Worker in Indiana and have been practicing for about eight years.  I am working towards a certification in perinatal mental health and infant mental health.

I specialize in

  • Postpartum Depression
  • Postpartum Anxiety
  • Postpartum Psychosis
  • Child Attachment and Bonding
  • Infant and Child Development
  • Adjustment Disorders
  • Relationships

Currently, I am accepting clients through Teletherapy and am NOT set up to take insurance at this time. Although the service would be private pay, I do offer a sliding scale payment for those that are interested. I have experience working with families, groups, and children in the public sector for several years. My work experiences include clients struggling with substance use disorder, domestic violence, anger management, anxiety, depression, bipolar, and many more.

I utilize many different interventions and evidenced based practices. Through cognitive behavioral therapy, motivational interviewing, solutions focused, client centered, person in environment, and others to help you get to your best life and achieve success in therapy. I am confident that we can create a treatment plan that will outline your goals and the steps we will take to succeed in them.

If you feel like we would be a good fit, feel free to reach out to me, my phone number is 317.679.2934 (call or text) and my email is TraciSchank@Gmail.Com, you can also visit my site, TraciSchankLCSW.com, if you want a peak into my practice. I can’t wait to hear from you!

THE LIES WE SELL

Many cultures mark pregnancy and newborn stages as a period of bliss, enchantment and peacefulness. Advertising and information sharing often show visions of mothers smiling looking down at their infants in a calm and peaceful environment. When working with my clients I usually make a joke about how, when you are pregnant, everyone tells you “being a mother is so magical”, “you are going to be so happy when they finally arrive!” and then in the newborn stages everyone shifts to saying “it’ll get better”, “once you get a routine”, or “sleep when the baby sleeps!”. Wait! What happened to all that magical and enchantment stuff? I felt tired, disconnected, sad, like I wasn’t getting it, it was hard for me, something was obviously wrong with me. That’s how I felt. In reality, I had been sold a lie. By advertisements, general information sharing and social media.

New moms go through a complete upheaval. Why are they not warned about this during pregnancy? I will be offering a class soon that address this very situation. There is evidence that BOTH mom and dad experience emotional complexity and transitions. Also, the roles are changing, someone who is a wife, girlfriend, daughter, business executive, etc, is now adding becoming a mother and the harsh reality of unrealistic expectations that our society puts on that. Add in some financial hurdles and a lack of support, WOAH! So much for enchanting. Then mothers feel like they are not doing it correctly. All because we sell a serenity picture of motherhood.

New moms are hard at work. They have to shift their prior attachments, they are forming some new attachment and figuring out what kind of mom they are (or dad). The coined term for the season is emotional upheaval. I recently completed a quick survey in my area and out of over 100 respondents 80% of them said that they were not screened appropriately during pregnancy nor after for emotional health. As one book put it “even when they [women] are consciously thrilled to be pregnant, regression, conflict, anxiety, transient depression, emotional liability, and ambivalence are inevitable-and profoundly adaptive, as they prepare the mother in a variety of ways for the enormous task before her.” Handbook of Infant Mental Health 4th Edition Ed by Zeanah, pg. 26. So, there you have it, it is completely normal to have ups and downs. It is normal to cry when you’re not sure why and to wonder “where’s all that magical stuff at?”.

Traci Schank, LCSW

Ghosts in the Nursery

Oftentimes, I ask pregnant moms and moms of infants if they have supports, people that can help them. They often just say “yes” sometimes added by “my mother lives close” or “my sister is supportive”. I usually reply and I understand they have supportive people in their lives, but when it is 3:00 AM and you are questioning every decision you have made up to that moment, who can you call? This is reality, not the picture of the mom smiling at her baby and talking about the unconditional bond of love and happiness she feels towards her baby. Sometimes, it is exhausting, we don’t want to respond, and we need help.

It is important to be honest with yourself and honest with those around you. If you don’t have many supports, let people know! There are free services that can be put in place to help you and at least be someone to talk to! The prenatal and infant stage have been shown to affect children as they age. If a child is neglected, not nurtured or responded to, it can greatly affect them for years to come. The goal is for the child to feel understood, accepted and loved. Infants do not cry out of manipulation, they cry because there is a need. Even if it is interaction that you just cannot seem to muster up, my advice, Fake it till you make it! I have encouraged moms to read to their infants, even if its a gossip column. Just something to encourage a positive interaction.

Positive parenting and guardians in the nursery can provide the infant with core sense of security and self worth that they can later draw upon as a child and adult, even when they have their own children. Break the cycle of maltreatment by understanding infant mental health, perspective, and needs. If those parents are absent, the outcome can last not only a lifetime but generations. Break the cycle of maladaptation. For more information, reach out to me or comment below with additional thoughts!

Traci Schank, MSW, LCSW

Zeanah – Infant Mental Health

Seasons of Receiving

Often, I talk to my new moms about the seasons of giving and the seasons of receiving. There are certain times, throughout a lifespan, that an individual falls into each category. For a new mother, she falls into the season of receiving, but why is it so hard for mothers to receive during their postpartum days? Why is it so difficult for mothers to ask for help? How often do providers discuss this with new moms and let them practice self-acceptance, and patients while knowing it is okay to reach out for help?

In a society that often judges and scrutinizes new mother’s on every single thing they do, from how they feed to what they dress their infants in, this can lead new mothers a little, hesitant, to reach out to anyone. However, research shows that that is exactly what they should do. Let the mother-in-law come over and hold the baby while you nap, tell them to DoorDash you some food, or accept a fruit basket at the front door. Small things can make a big impact and impact overall mental health.

When one in five to seven women are being diagnosed with Perinatal Mood Disorder, sleep (while not the cure) can help greatly. So, mommas, if you have supports that can help you, lean on them.

A lot of mommas also think they are going to go home and keep on cleaning, cooking and doing dishes. Only to have a reality check that a lot of this expectation of yourself or your spouse is too much! Let the dishes be dirty for a little bit, let the laundry build up, let the mother-in-law’s clean! You are in a season of receiving sister. Receive it and don’t judge yourself. Be mindful of the thoughts you are telling yourself and that you allow yourself to think. This isn’t easy and no momma, no matter how easy they make it look, knew every answer. We try, we fail, we try again, we guess, we get tired and loose our cools and that’s okay. Good mommas have scary thoughts sometimes and THAT IS OKAY. Thoughts don’t equal actions. Take some time, realize when there is a real problem and allow others to be the givers right now.

Stay Healthy!

Traci Schank, MSW, LCSW

Perinatal Mood Disorder Screening in Healthcare Settings

As Americans move to a more mindful and pro-mental health outlook, one of the of areas that needs some attention is new and pregnant mothers. The time period that a woman is pregnant, up to a year postpartum, is considered the perinatal period. Post-partum depression, anxiety, psychosis, and antepartum depression are all encompassed under the phrase ‘Perinatal Mood Disorders’ or PMD. More resources for the PMD population would, I believe, create positive outcomes that last long-term for mothers and their infants. PMD has been shown to cause long-term adverse birth outcomes when it goes untreated.1 Below, I will outline some surprising statistics as well as some outcomes, resources and possible solutions for providers of pregnant women and women with infants.

Research shows that 1 in every 5 to 7 women experience postpartum depression.3 Also, 1 in every 10 fathers or spouses experience postpartum depression.3 If a woman experiences PMD her partner is more likely to also experience PMD. Over 50% of women that are experiencing symptoms of perinatal mood disorder are not identified.1 This is a truly unfortunate statistic because research has also show that women are more likely to come into contact with a health provider during their prenatal period than any other time in their life. Even though women are coming in to contact with health care providers, they are not being screened, why?

A common reason why providers do not screen for mental health during the prenatal period is due to lack of resources. Providers do not want to dig for problems they cannot fix. However, I do believe this is just a lack of education, there is support out there, if you look. Providers also seem to focus on the medical aspect of a pregnancy. During this time women may be seeing an OBGYN who does not feel comfortable discussing mental health or does not view that as their scope. Research shows however the PMD for women is more prevalent then preeclampsia, breast cancer, and diabetes.1 Also, in 2015 the American Congress of Obstetricians and Gynecologists reamended that women be screened during their prenatal period at least one time.1 Physicians may not be aware of appropriate tools to screen (like the EPDS or PHQ 9). Aside from healthcare providers not screening for PMD, mothers are also hesitant to reach out for help. Despite how common PMD is in women, as a 2016 Lee Research Review points out, “few women seek professional advice due to physical and attitudinal barriers, long-waiting times for face-to-face psychotherapies, social stigma and uncertainties about the potential risks of pharmacological therapies during pregnancy”2

                  Adverse outcomes are a probable outcome of Perinatal Mood Disorder. Including a decreased attachment and stress on the fetus.  If you identify PMD early, it can change these outcomes and increase the infant-parent bond. Subsequently, women should be screened at least one time during their pregnancy and up to one-year post-partum. Research shows that the prevalence of depression typically peaks around 3 months postpartum. 2

                  What are some good resources for Perinatal Mood Disorder? I would encourage all new moms and especially anyone at risk to get adequate rest, exercise and nutrition. However, I know first-hand that is easier said than done. The first one that I would recommend is talking to your doctor about is. Getting some physician input on potentially starting medication or a therapist referral would be helpful. Physicians can help direct you to PMAD’s and treatment. The second thing I would recommend for mothers, is locating the Postpartum Support International (PSI) website. They have around the clock help and support available, as well as websites, blogs, etc. There is much more information on this topic that I will delve into piece by piece over the coming weeks. Including prevalence and resources.

As always, feel free to leave a comment! Is there something you learned or something you feel I left out? Drop a comment in the section below!

Take Away Points

  • 1 in 7 women are diagnosed with Perinatal Mood Disorder
  • There are many reasons, including stigma and lack of support, that women do not come forward with feelings of PMD.
  • Women should be screened prenatal and at pediatric appointments for PMD.
  • Resources : Local physician or community health partner; Social Worker for Women and Children; Therapist; Stress Reductions Techniques; Prenatal Massage: Prenatal Yoga; PSI; Online support groups; Telehealth and Teletherapy.
  • YOU ARE NOT ALONE

 

References

  1. Accortt, E., Wong, M., 2017. It Is Time for Routine Screenings for Perinatal Mood and Anxiety Disorders in Obstetrics and Gynecology Settings. Volume 72, Number 9.
  2. Lee, E., Denison, F., Hor, K., Reynolds, R. (2016). Web-based interventions for prevention and treatment of perinatal mood disorders: a systematic review. BMC Pregnancy and Childbirth 16:38 DOI 10.1186/s12884-016-0831-1
  3. Postpartum Support International; https://www.postpartum.net

Consumerism and a Pandemic

I hate consumerism. I really do. However, I am not strong willed enough to always practice what I preach. I used to be, before I was a parent. When I was twenty years old in my old studio apartment, I had little furniture. Really, I had little in general, I dreamed of days where I could own nothing and get by on nothing. Then I got pregnant and things changed. While I still view that time in my life very positively, I struggle practicing that as much. I still purge a lot; I do not have emotional attachments to my things. However, I consume much more, and I give in to my child consuming much more. The pandemic, stores being closed, and “essential shopping only” has really brought this idea, once again, to the forefront. My four-year-old son at one point was crying out “I JUST WANT TO GO SHOPPING!” and “I WANT A NEW TOY!”. I had to step back and consider, what happened? What happened to the person I was not long ago?

Is the pandemic going to create better consumers? While research varies, from 21 days to months, I suspect the pandemic will cause some changes in our behavior long term. However, what about shopping? Is it done? Are we going to shop online more now? Are people going to shop less because for months they couldn’t shop? Will people realize how much money they were saving? Or, once this is over are people going to be excited to be able to go out again and shop a lot?

I suspect that the answer will depend on the type of person and how hard the pandemic hit you. Speaking mostly economically. If you were hit hard; lost your job, lost your savings and found yourself waiting at the food pantry for the first time in your life, there is going to be some trauma. Likely, thinking of disposable income and the things you feel are necessities, is going to be different now. However, if life went on as usual; working from home, same income, no real hiccups except for the inconvenience of not finding toilet paper and ground beef, you may be more apt to celebrate when the lock down is over.

A family member and I were just talking about how quickly the ads on TV have changed to talk about social distancing, cleaning, or health. I am sure that there will be a similar response when the country opens back up. However, no product (yes, even a gallon of hand sanitizer) is going to make you feel better after the trauma of a pandemic.

Consider the following quote from an article published by Alexandra Pastore on March 17, 2020 (link below):

“The outbreak is affecting overall decision-making on quality as well. According to Red Point’s data, 31 percent strongly agree and 27.9 percent of consumers somewhat agree that they are “currently more likely to make snap purchasing decisions when shopping online because I am scared that these products will sell out due to the coronavirus outbreak.””

I would encourage all to take this time to think about the topic of consumerism. How has it changed your life for the better or worse? Is obtaining these goods and services ever going to lead to satisfaction? Will you always want more? Does tomorrow ever come? Perhaps this is a good time to look inward and decide if your spending correlates with your long-term goals. A time to consider how you shop, what is essential? A time to think about how your mental health affects your shopping decisions (because it does and so does your sleep!).

What do you think the outcome of Coronavirus will be for the average consumer?

Traci Schank, LCSW

LINK:

Understanding Consumer Shopping Amid Coronavirus Pandemic

RESOURCES

If you are in an emergency situation, please contact one of the following hotlines for assistance:

Why the Child Welfare System is Impacted by COVID-19

With COVID 19 taking center stage in the media along with the health and financial impacts; there is not a lot of mental space to add child welfare into the mix. However, considering the statistics that is exactly what we need to focus on. With children being isolated at home, abuse rates are likely to increase. Children will have no doctor or dentist visits as well as closed schools, resulting in minimal interaction, if any, with mandated reports. The pandemic is creating illness, financial devastation, food insecurity, stress, depression, anxiety, and unemployment at unprecedented rates and it creates the perfect storm for child abuse. One article on AJC.com also points out that courts are shutting down, visits are being suspended, and foster parents may be less likely to take children due to possible COVID.1

Likely the above situation is going to create a surge in child welfare cases and foster care placements after things start to open up again.

Research shows that during past pandemics and recessions cases have skyrocketed. In my personal experience in child welfare (approximately ten years), child welfare cases tend to decrease during the summer with an increase when school starts. The pandemic is closing everything at unparalleled speed. Including the child welfare system itself. Lack of visitation providers, therapist, support groups etc. The impact this will have on children will last years. Please see below for some helpful resources and tips. How can YOU help?

Helpful coping tips:

Reach out for help, resources like Children’s Bureau offer programs like NACS, Neighborhood Alliance for Child Safety, which are there to intervene before a more formal system has to.

Reach out to support systems even if that is virtually.

Remember self-care, take a break, walk away from a crying infant for a few minutes to calm down.

Helping tips:

There are many ways to access resources including 211, Trustee Office, Adult and Child and Children’s Bureau. New resources are popping up every day in Indiana with local companies trying to help. I would encourage a quick search on the internet or a call to 211 to find immediate resources. The CDC and Department of Urban Housing have also issued different resources for homelessness. CWLA.org has a nice navigation of COVID Resources including topics for social workers,

Remember, we are all mandated reporters in Indiana. The Child Abuse and Neglect Hotline in Indiana is 1-800-800-5556.

  1. https://www.ajc.com/lifestyles/why-surge-foster-care-placement-will-follow-covid-pandemic/NKtnijOQwZpfsL8XypJsrL/

Perinatal Mood Disorder Snapshot

Statistically, 1 in 5-7 women get Perinatal Mood Disorder (postpartum depression). PMD causes many negative outcomes including preterm labor, low birth weight, insecure attachment…studies have shown impacts can last into adolescents. There is a positive correlation with maternal anxiety and depression and preeclampsia. Yet we are much more likely to only screen for preeclampsia prenatal. It is time to screen moms for PMD during their pregnancy!A4835043-AF5D-4248-8B64-919F4EB38E32