DIVYA KUMAR, LICSW, MSW, ScM, PMH-C
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The “village” and collaborative parenting as a means to selfcare  

9/19/2016

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Picture#thisismyvillage
New parents are inundated with instructions and advice without the concrete support and information necessary to create sustainable changes in their lives.  Included in this onslaught of advice is to find time for selfcare: we are often quick to say-- with the best intentions -- “Oh, take care of yourself!  Do something nice for you!”  

Our suggestions, instructions, and advice are meaningless if their recipient has limited means to turn our words into a reality. Unfortunately, numerous barriers-- such as finding and paying for childcare, getting time off of work, and/or not enough hours in the day-- stand between new parents and sleep, exercise, more nutritious food, and, especially “me” time.  Selfcare, along with various other “healthy” behaviors, occurs (or doesn’t) within a socioeconomic and cultural context; instead of focusing on what new parents should do, we need to focus on changing the larger context in which new parents make choices and initiate behavior changes.   

Part of that contextual shift means changing norms around how parents connect and rely on each other to support each other’s wellbeing.  The groups I facilitate are parent-centered, meaning that I try to focus our discussions less on the baby and more on our experiences as parents.   In my groups, whenever I remind moms that we are not supposed to do this parenting thing alone and that it’s OK (and essential) to ask for and to accept help from others, many of them say, “But I feel like I’m supposed to be able to do this myself; I mean, it seems like everyone else is managing without help, right?”  When we are inundated with images of the supermom who does it all, asking for help can be a sign of weakness in a culture like ours that values independence and self-reliance over community and collaboration.  

We throw around phrases like “it takes a village,” but we don’t have great or even good realistic images or stories of what that village looks like or even what it takes to build or access one.  How do parents work together to create sustainable support systems?  A lack of concrete information and visible models of a modern day “village” lead to two things: 1) new parents often don’t know HOW to create support systems, which reinforces that 2) this type of inter-dependence is not the norm and therefore seems uncommon or even weird.  

One way to provide that framework may to be integrate the concept of ‘making your own village’ into perinatal education and new parent groups. For example, in the groups I facilitate, I focus less on providing information (since new parents are already inundated with it) and more on building community and connections. I stress to folks with new babies that getting out to a new parents group can help folks to meet people they can call or text if they’re having a bad day or are bored or just need to get out of the house - that their groupmates will both ask for and give help back to each other. In addition, it’s helpful to provide new parents with the tools for collaborating and relying on each other to mitigate some of those aforementioned barriers to selfcare.  No, the village can’t solve every problem but having a group of peers to count on can go a long way when it comes to getting chores done, carving out time for oneself, or just getting a little room to breathe.  

Another suggestion for new moms is that when they feel stuck at home with chores to do (e.g. laundry to fold, emails to return, dinner to prep) is to ask a couple friends over to watch and entertain the babies while they can attend to their chores.  It’s amazing what can get done in an hour, and a couple friends will be more than happy to come over, bring sandwiches, and take care of the babies while the hosting parent knocks a few things off that growing to-do list.  And here’s the thing: the next week, the hosting parent will be more than willing to go to a friend’s house and do the same thing for them.  It sounds radical, yet also completely simple and practical.  Yes, it takes a village, and this is how new parents can create theirs.  

Similarly: a group of four moms can meet up, and two moms can exercise while the other two each have a baby in a carrier and push another in a stroller.  And then they switch.  Everyone gets time to exercise without juggling a baby at the same time.  A group of moms did this about a year ago at a beloved green space in our neighborhood, and I mention this arrangement in my groups whenever someone wonders how they’ll find time to exercise as a new mom.  

Ultimately, helping new parents find ways make small changes in their routines to build community supports the larger goal of expanding visibility and changing norms around what parenting looks like.  What if helping each other was the norm, and not so unusual or only reserved for extenuating circumstances?  Parents shouldn’t feel like relying on friends or helping friends only happens when someone has surgery, when the car breaks down, and when the whole family has the flu; rather, collaboration should be a visible part of how we parent every day.  It’s hard to be—or feel like you are-- the only one who’s asking for help, and if we SEE models of collaboration and interdependence, new parents may be more likely to engage in those behaviors and in turn ask for, accept, and offer support to each other.  

Now that my children are 9 and 7 and I have a wonderful network of friends, I don’t hesitate to ask someone to watch my kids at the playground if I’m running late.  The days of swaddles and pacifiers are long gone, and I can unequivocally say that my support network has sustained me as a parent over the years.  But when you’re a new mom and you’re meeting folks for the first time and making new friends, it can be hard to ask for help since you’re asking strangers for help, and also because the image of the self-reliant mom who does it all (with a smile and eye makeup) is so pervasive.  If we can change expectations and norms of what parenting communities look like, we can help moms create that village early on and during a more vulnerable time—and in turn can promote the adoption of positive health behaviors like selfcare.

The tricky piece about behavior change is that it can take time to figure out and implement changes in a sustainable way; the trickier piece is that changing the larger social context can be glacially slow.  If after reading this post you find yourself thinking, “OK, I agree, but what am I supposed to DO about it?” Here are some suggestions: talk to your pregnant friends about how important it is to ask for, offer, and accept help from other folks.  Remind them (repeatedly) that no one is supposed to do this alone, and that a network of friends is a stronger and more durable lifeline than a specific swaddle blanket, diaper cream, or bouncy chair. Give your pregnant and new parent friends gift cards for takeout or meal-prep services as baby shower gifts.    

We also need to fight the narrative of the supermom who does it all on her own.  Are you part of a meal-share or childcare co-op or a carpool?  Do you text your friends when you’re going to Target and grab school supplies and extra underwear for them?  Post a status or a photo on social media and use the hashtag #thisismyvillage to build visibility of what support systems—a real village—can look like.  

​Selfcare would be less radical and more accessible if we reduced the barriers for each other; part of making selfcare a reality is groupcaring for each other.  To reduce the stigma associated with asking for and accepting help, we have to change the social norms of what parenting communities look like.  If you work with new and/or expectant parents, talk to them about how to create a village.  If you have a village, make it visible.  Changing social norms to promote positive changes can begin with all of us today.

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Turning teachable moments into systemic changes

10/22/2015

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​Last week, my social media feed was abuzz with folks discussing Hayden Panettiere’s disclosure of perinatal emotional complications.  The young actor openly discussed her struggles and her decision to enter treatment.  Today, I read that Drew Barrymore discussed her own similar struggles after the birth of her second child.

When a celebrity publicly admits to struggling with a mood or anxiety disorder, an opportunity for a teachable moment presents itself, and, for the most part, we have taken advantage of this moment.  I have seen so many constructive, informative, helpful discussions of perinatal emotional complications.  More importantly, women who struggle or who have struggled with similar emotional challenges can look at these famous women and know that they are not alone and that they too are battling a similar illness.  

Nearly 1 in 5 women will experience an emotional complication during pregnancy or the first year of their child’s life; emotional complications are the most common complication of childbirth.  Even so, admitting to a mood/anxiety disorder is a courageous act, one that opens a mother up to scrutiny and criticism.  Panettiere has received a great deal of praise and gratitude for speaking candidly, and, from what I have seen, folks are praising her honesty, courage, and willingness to speak openly about something that many women struggle with in silence.

While Panettiere should be commended for speaking out, it’s worth noting that speaking honestly about perinatal emotional complications is something not all women can do. Admitting to experiencing perinatal emotional complication--let alone having the ability to seek and receive treatment--is a privilege.  

The rates of perinatal emotional complications are nearly twice as high among low-income women and women of color, compared to white, middle class women; yet, women in these populations receive screening and treatment for emotional complications at much lower rates.
For many mothers, the challenges of unstable housing, poverty, unsafe neighborhoods, and racism may eclipse the need for mental health services.  Furthermore, women of color and/or women who are economically disenfranchised may face numerous barriers to seeking and receiving care, including cultural stigma, lack of mental health providers who accept Medicaid, lack of culturally or linguistically appropriate services, lack of childcare, lack of transportation, and fear of their children being taken away.

During the past week, while social media has been abuzz with Hayden Panettiere’s story, I have been remembering Miriam Carey, the woman who was shot and killed by police after a driving into a blocked gate at the White House and a subsequent high-speed car chase in Washington, DC in October of 2013.  Articles written about Carey include statements about how she had suffered from “mental illness” (although it’s unclear if this was confirmed).  Her mother stated that she had had postpartum depression following the birth of her daughter during the previous year and that she was hospitalized for this.  

I cannot help but compare the two mothers: one of whom, Hayden Panettiere, is a white celebrity with access to resources, and another, Miriam Carey, is a black woman who was a dental hygienist.  One is in treatment for postpartum depression; the other is dead.  Why?

We can only speculate on how Carey’s life could have been different, and the “what if” questions are endless.  What if she had access to different mental health services?  What if she had been able to take unlimited medical leave from her job?  Did she have a supportive community around her?  Was she able to see a mental health provider of her own racial/ethnic background?  The questions and speculation are limitless.  

When discussing her struggles, Barrymore stated, “It was just really challenging and I felt overwhelmed. I made a lot of decisions and I definitely changed my work life to suit my parenthood.”  What if Carey-- and ALL women-- had the ability to make these choices?  What if new mothers didn’t have to worry about losing their jobs, jeopardizing their income, or fear having their children taken away from them?

Panettiere’s disclosure is encouraging women to speak up and is validating the struggles of so many parents.  While we praise her courage, stand with her, and wish her well through her treatment and recovery, we must also look beyond the act of her speaking out and examine the larger systems of privilege and resources which support her ability to speak honestly and to seek and receive care.  

What would it take to change systems of healthcare so that all women are supported like this?  To de-stigmatize perinatal emotional complications, providers need to screen women early and often (during pregnancy and through the first year of their child’s life) as part of routine obstetric, primary, and pediatric care.  To de-stigmatize the utilization of mental health services and to increase timely access to these services, we need to embed mental and behavioral healthcare into existing systems of care, such as primary care, obstetrics, and pediatrics.  To provide culturally appropriate and accessible care, we need more mental health providers of color, more mental health providers in settings like community health centers, and more Medicaid coverage of mental health services.
​

Panettiere’s story has panned out to be a positive teachable moment, and many people are now discussing struggles with emotional complications more openly.  But why wasn’t Miriam Carey’s story-- and death-- that teachable moment?  Perhaps because, in many communities, speaking honestly is not enough or is not even an option.  While the discussions of the past week are constructive, we also need to focus on building and bolstering systems of care that ensure that ALL women can disclose their struggles and seek and receive the care that they need.  


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All of the Feelings During Back-to-School Week

9/13/2015

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Last week, my social media feed was full of back-to-school photos.  Kids with smiling faces holding signs with their school year, kids with backpacks on and running to the bus, kids waving to the camera, siblings holding hands and walking together.  Along with these photos were captions of “Mommy is melting” and “Fighting back tears” and “Very dusty in here today”.  These testimonies of bittersweet emotions at how our children are growing up have been a dominant narrative this week.

 Along these lines, what we don’t see are the photos of moms who are cheering and jumping for joy when the school bus arrives.  We don’t read the posts that say, “I needed a break from my kid and did not shed a tear when he left for his first day of kindergarten”.  We don’t hear the invisible (but still palpable) exhales of moms who have been waiting for this day to come.  Representations of back-to-school experiences that deviate from the dominant narrative are far less common and are almost completely absent.

 Here in Boston, we tend to be a seasonal city, and September is a time of transition for many families.  That transition can look different for different families, and when your experience differs from what social media depicts as common and therefore normal, it can be challenging to discuss these differences publicly.

 We read many updates that mention “all of the feels”, but what isn’t explicitly discussed often enough is the feeling of RELIEF.

For many parents, sending their kids to school brings a great deal of relief—emotionally, mentally, and financially.

During the summer, many moms and parents struggle find childcare, struggle to pay for that childcare, and/or struggle with transportation to that childcare.  Parents who are home with their kids may want a break and may long for peace, space, silence, and a moment to think about what’s next in their own lives instead of constantly reacting to their kids and their kids’ needs.  For many parents, school represents a free, safe place for kids to go every day—a known entity that brings routine and stability.

 What does this mean for those of us professionals who work with parents and families?  It’s important for us to not make assumptions and instead ask open-ended questions.  By doing this, we can create space for folks to express a range of feelings—sadness, pride, worry, uncertainty, joy, and relief. The pressure to feel sad or bittersweet can be quite strong, and for moms who feel something quite different, that dominant narrative can make them feel abnormal, out of place, and like a bad mom.  For a mom who doesn’t feel the way social media tells her she’s supposed to feel, the ability to speak honestly without worry of judgment can be a welcome respite from the barrage of pervasive images and messages.

 We can love our kids and love being away from them.  Just because we love our kids doesn’t mean that we enjoy every moment with them.  Just because we love our kids doesn’t mean we’re sad every time they leave or move on to a new phase of their lives; those changes can bring comfort, relief, and security.  Parents can simultaneously hold feelings that, on the surface, may seem in opposition to another, and we as professionals can normalize this.

 So, yes, parents—bring on all of the feels.  Really, ALL of them.

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