Latest / The Birth Lounge Podcast / Ep. 477: OCD and Postpartum Intrusive Thoughts with Špela Grašič

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Ep. 477: OCD and Postpartum Intrusive Thoughts with Špela Grašič · The Birth Lounge Podcast

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You are not a bad mom.
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Something like 65 to 96% of new parents experience intrusive thoughts.
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You are not broken for having these thoughts.
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You are not your thoughts Hello and welcome back to another episode of The Birth Lounge podcast.
How blessed are you to get to hear me sing twice a week? I mean, honestly, la, la, la la, la, la Actually, anytime that I get a hoarse voice or I start to sound a little nasally, you know, thanks to allergies, I do, it is one of my first thoughts, like, "Oh, my God, how am I gonna sing for my people? How am I gonna sing the song of my folks?" All right, you guys.
We talk a lot about postpartum and what it's like to be a new mom, and one of the things that I really don't shy away from on this podcast is talking about mental health.
And the reason being is I find that our country in general is really apprehensive to talk about mental health.
Not only do we not prioritize it when it comes to funding, but we want to have all of these hush-hush conversations about it.
Normal mental health struggles are not normalized at all.
They are actually very taboo.
And now you take that and put it in motherhood, which is already a really...
Ugh, it's, it's like a time in life where everything is judged, and there's so much shame, and there's so much guilt, and there's so many conversations about, you know, what's normal versus what's not normal, and if you don't fit exactly into this ticky-tacky little box, then you must be the weirdo in the room.
And, you know, that is just simply not true Now, on a previous episode, we have covered intrusive thoughts with Dr.
Kat, and we will link that episode in the show notes.
But I wanted to cover postpartum OCD, and more than that, I wanted to have on someone who has experienced OCD and postpartum intrusive thoughts to share what that experience was truly like.
What did those intrusive thoughts sound like? What did it feel like to be in those moments So today I'm so excited to be sitting down with Špela Grašič, who is a new mom and a registered clinical counselor from BC, which is in Canada.
Her journey into mental health started over a decade ago when a friend said, "Maybe you should talk to someone."
Yes, like the book, Maybe You Should Talk to Someone.
She did, and over time she transformed her relationship with herself and her thoughts.
She now sits with others as they learn to hold, untangle, and tend to all the messy, painful stuff that might pop up postpartum in motherhood.
Špela holds a Master of Arts in Counseling Psychology from Yorkville University and a Master of Arts in English from the University of British Columbia Špela Explored how intergenerational trauma encapsulated in everyday interactions, institutions, and languages impact people.
Professional qualifications aside, Špela is a quirky, sometimes awkward, new mom, partner, sister, daughter, and friend navigating the messiness of a rich and fulfilling life.
Hey, aren't we all? I'm so excited today to talk about personal biases and how birth trauma impacts the ways that we show up in postpartum.
What are some things that your partner and your family and your friends can do to support you if you find that you're experiencing postpartum OCD? What does it look like for your intrusive thoughts to be alleviated versus be escalated? And then finally, Špela's going to give us some advice on what you can do if you are experiencing either postpartum OCD or intrusive thoughts As always, when it comes to mental health conversations, if you're not in a place to listen to this right now or listen to intrusive thoughts go ahead and hit that pause button.
Špela and I will be here, well, forever.
This episode's gonna live on so that you can revisit it in a time that feels best to you.
You're not gonna be missing out on anything.
You can always come back to this episode when you are ready I think one of the best things that you can do in your life and to make you feel more comfortable and more confident in your motherhood journey is to do a little introspection and talk about mental health openly and to get the support that you need if you need.
You always know that you're safe here to do those things.
Without further ado, Špela, welcome to the show.
Hi, thanks for having me.
Oh my gosh, truly the honor is mine.
I'm so excited for this episode.
I'm so excited to dive into you know, a topic that I think feels really taboo.
Like, nobody wants to go around saying, "I'm having intrusive-" Yeah thoughts.
But kinda before we recorded, we were saying it's pretty normal, right? Like, it's- Yeah the- these are things that happen in postpartum.
These are things that a lot of moms experience, but they can feel embarrassing and they can feel really shameful and they can feel like, "Oh my gosh, I don't think I should tell anybody that I'm having those thoughts," but the opposite is actually true.
You do wanna tell people that you're having those thoughts, especially, especially if, you know, the thoughts feel really overwhelming or debilitating or if you feel as if you might act on one of those thoughts.
It's really important that we that we do tell somebody.
But before we dive into all that, I'll give you guys a little disclaimer.
Špela does have her baby with her, so you're gonna hear some cute little, you know, grunts and coos and stuff, and I miss Saggy Boy.
I, I kinda wanna go grab him and be like, "Let's have a party."
Um, but, you know, Špela, talk to us about your first introduction, your experience with intrusive thoughts.
Yeah.
So I've actually had intrusive thoughts for two decades now.
Mm.
Um, I was diagnosed with OCD before I got pregnant, so I was familiar with them before that.
I had some of the more taboo ones more difficult to diagnose.
So I was expecting this in postpartum.
But in postpartum, I think probably the most taboo one, and the one that would've been the most unsettling to me if I didn't have prior experience, is it was early on, it was in the first kind of four weeks.
I was totally sleep deprived.
I was feeling some postpartum rage at just I don't even know what, and I was just exhausted and absolutely terrified of something happening to my baby.
And at one point he was just crying and crying, and I couldn't figure out what it was.
And I was like, "What am I doing wrong?" We were having breastfeeding difficulties, and I just had this image of getting so upset and so overwhelmed that I just chucked him at the wall.
Or like And I was like, "Whoa, that was All right, that's an intrusive thought."
And I think because I was able, because I'd had those thoughts previously, I was able to recognize I'm sleep deprived.
Like, I'm so sleep deprived I'm practically dissociated.
This was an imaginary thought of what could be possible in a kind of an alternative world.
But it was a very real, like, not real, but very, like- a physiologically intense thought.
It kind of, almost like I was in a movie watching that happen.
So that was probably the most taboo one I've had.
Most of mine have been around things like something happen- happening to my child driving along the road, vivid images of an accident happening.
Almost every time I walk through a door, I have this image of, or I used to, it's getting better now eight months post, um, but it used to be every time I thought I bonked his head, or every time I would put him down, I was like, "Oh.
Oh my God, I smacked his head."
I never smacked his head once.
But my, in my brain I was almost imagining that's what I was doing.
So those were pretty unsettling.
And then I'd have these, like some of them are really creative.
One of them was I was my dad took him for a bit, and I had this like great image, or not, I was living the movie of my dad having a heart attack, letting go of the stroller, the stroller going into traffic and getting hit, and it was like I was in that reality of that happening, kind of like I could watch it happen and I could feel in my body what I would feel if that was actually happening.
So they were, there were a few that were really quite intense.
Yeah, tho- tho- those were some of the ones, um, that I had personally.
Luckily there, uh, there's a lot worse ones you could have.
Um, but those were mine.
Now, going into it understanding what they are must be a very different experience than someone who's never had an intrusive thought in their life.
So I'm kind of in the in between, right? Like- Mm-hmm I had never had intrusive thoughts before, but because of the work I do, I was very well aware of them.
What advice do you have for a f- a first-time mom who's never had intrusive thoughts and, you know, maybe you're, maybe you're listening and you, you're expecting your first baby.
Hopefully, that's where you are in your journey.
But even further, for someone who's just had a baby and they don't have kind of that, that runway of leading up to having a baby, maybe we're in it right now, what would you have wanted to hear as a first-time mom going through something like that? This is normal.
Mm.
This is normal.
You are not a bad mom.
You love your baby.
You do not actually want to hurt your baby.
You won't hurt your baby.
You are not a risk to your baby.
Intrusive thoughts are a normal part of pregnancy.
The research says that something like between 65 and 96% of new parents experience intrusive thoughts, and up to 10% might experience symptoms that are clinical for OCD at some point postpartum.
And those, the research that we have, the moms that have thoughts, intrusive intentional harm thoughts, these are unwanted, unbidden, they just show up thoughts.
Those moms are no more likely than moms who don't have thoughts to actually harm their child.
Mm.
So you are normal, and you are not bad.
So I just got a little teary-eyed because I can picture the relief of someone out there who's, like, so scared, and they're like, "I'm a bad mom."
Like, "I must be crazy.
I must have mental health stuff."
Like, "What's going on? Why am I having these bad thoughts?" I can just feel the relief when you said, like, "This is normal," right? I was sharing before we recorded, I am, I too am eight months postpartum, roughly, and, um, I just started having them.
And I think for me- Mm that was a little bit of a shock because I remember Around the six-month mark, I was actually feeding Saggy.
We were sitting on the couch nursing, I remember it like it was yesterday, and, um, I looked down at him and I was like, "We made it out."
Like, we, we made it.
We made it out of- Mm-hmm we're six months.
Like, this is where everything drops off, right? Like, I should start feeling a little better.
Our breastfeeding relationship, we made it.
Your sleep is good.
I haven't had any intrusive thoughts.
Like, s- your SIDS rate goes down at six months.
Like- Yeah there's just so many things that once you make it past those six months, it feels like you've made it to kind of a new level.
Well, last week, I was in the bank and this sketchy guy came in at the same time that Saggy and I did.
And, you know, recognizing my own, fully owning my own biases, it was my- Mm-hmm judgment of him that he was sketchy.
He didn't do anything that made him sketchy in my brain.
It just- Mm-hmm he looked sketchy, and he was carrying himself sketchy.
What he was wearing- Mm-hmm looked a little sketchy to me, and it made me feel unnerved.
Fully recognizing that is my own judgment of him, but it made me really unsettled, and immediately I had the thoughts that he was going to shoot the bank.
He was gonna, like, b- it- Mm-hmm we were gonna be in a hostage situation.
I started sweating.
I, like, held Saggy very close.
I put him i- I, at first I had him on my hip, and I put him in front of my body, and I positioned my body- Mm between the guy that was behind us so that he couldn't see Saggy.
And then as soon as I had...
I needed to get something notarized, so I had to go to the teller, tell her what I needed, and then I had to wait for another person at the bank to come- Mm-hmm and get me.
And instead of going to the waiting area, which she directed me to, I went and stood right by the door, and that is where I waited.
Mm-hmm.
And so I think it really caught me off guard of just, like- how intrusive it wa- I mean, it felt very real.
You, when in the opening you said- Mm-hmm like, "They're imaginary, but they don't feel that way."
That's exactly how it was for me.
It felt like we were in immediate danger.
And I, it was, it really struck me how- Yeah strong it was.
It, like, genuinely took over my entire brain.
It took over my whole body.
I mean, I was truly in fight or flight.
When I got up to the teller, I couldn't even really engage in niceties.
I, I basically was just like, "I'm here to get something notarized, please."
I mean, I couldn't even muster up, like, "Hi, good morning."
Like, "How are you doing?" Like, I needed to get in and out.
I needed to get my stuff notarized, and I had to leave, right? Like- Yeah that guy had shaken me up so badly, and I remember thinking kind of those things being not a mom, I think before I had Saggy.
And it was always one of those things where, like, of course, I would kind of like map out, like, all right, what would I do if that happened? But I never would move myself to the door of the bank.
I would still be able to enga- I guess, like, it just hits so much differently when you have a baby.
Mm-hmm.
It's like, it's very visceral.
It's almost like you've stepped into an alternate reality where that's happening, and you can feel it.
Yes.
Yeah.
Oh my God.
The, I mean, you just described it so perfectly.
Why do we get intrusive thoughts? What is the driver behind that if it is so normal? Is it hormones? The research, we don't From what I've been able to figure out there's a lot of avenues for research, and for they're kind of bouncing off of the research for intrusive thoughts, which I think we mostly have around OCD, and there's a few different theories.
Hormones is one of the theories.
Yeah, different receptors for, uh, neurotransmitters is another theory.
Sleep is one.
Sleep has been linked to worsening symptoms.
And interestingly, if you have OCD, there's some research that suggests that if you have a later bedtime the symptoms get worse which you can't avoid when you're a new mom.
You're gonna have later bedtimes.
There's some research that suggests some sort of connection between, um, attachment, and indirectly potentially with adverse child events.
Um, genes have also been explored as So there's lots and lots of different theories for why we get them.
I kind of think personally Britta Bushnell writes in Transformed by Birth, she talks about how, um, how birth is kind of a face-to-face also with death, um, where we're faced with kind of the fragility of life.
And I think in postpartum you are all of a sudden, you have this huge, immense responsibility in a way that you have never had before.
You are completely responsible for this tiny little human who's completely dependent on you, and they are so fragile, and I think our brains are primed to think of what could go wrong.
And I think as p- and a, a lot of us are really kind of, We're very empathetic, very very caring individuals, and we take that responsibility really, really strongly.
And so then of course we can imagine us failing that responsibility, and the shame and guilt and grief that we could feel.
And I think another piece of it is, is we hear all these horror stories of things going wrong or people being, quote, unquote, "bad," and we also have that empathy to be like, "Wait a minute," like, "I'm only human too.
I can make mistakes too, and if I make a mistake now, the consequences are bigger than anything else I've ever done."
And then your hormones are shifting, your body is shifting.
I was listening somewhere that also your like, your threat response and like, like there's several body systems that are making you more primed to assess for a threat and be more responsive to it in postpartum.
So I think all those factors put together then add the separation, add potential duration, the changes in your relationship how many supports you have, threats about, like stressors around money, and it's just, it's a perfect situation for your brain to be like, "Oh my God.
Oh my God.
What's gonna go wrong? Let me imagine.
Let me almost practice it."
But then we also experience the thoughts themselves.
But if you have intrusive thoughts of harming your child a- intentionally even though you don't want to, I think then the thoughts themselves can also feel threatening, and then now you've got like another loop of stressors and all that coming together to just be a big emotional mess really Yeah, look, you ain't lying about the whole, you know, your, you, your threat responses stuff.
Like that, it it's something I'm still dealing with.
I, I feel like I notice threats way more than I did before I had Saggy, right? Like, of course I kinda knew the world could be dangerous, but like, I don't know, I always was like, "Keep your head on a swivel," but it's, and i- I guess, like, when it was just me, I kinda was like, "Meh, okay.
The world- Yeah can be dangerous, but like don't walk with headphones, don't, you know, walk down alleyways at 2:00 a.m.,
like, you know, be mindful of where you park your car," you know, things like that.
But now, it's like, no matter what time of day, I am always looking in parking lots.
No matter where I park my car, I am always noticing who is parked beside me, what kind of car is parked beside me.
I'm even looking at license plate numbers.
I mean, I am so mindful of...
I'm not an aggressive driver by any means, and I'm not like a crazy driver by any means, but now I'm so careful of like, okay, I don't wanna, I don't wanna get over right now because I, I don't want any chance for that person to think that I had cut them off, or I don't want them to think at all that I got too close to their car because what if they get angry, they're really crazy, they're having a bad day, and they pull out a gun and shoot me? Or, you know, what if they follow me to our next destination and they kidnap me and my child? Like, literally thoughts that have never crossed my mind before.
Mm-hmm.
And things that, for a lot of people, they might hear and be like, "Hehe, that's crazy that you would think that."
But these are the things that cross your mind when you are in that heightened state of new motherhood of having that responsibility that you do have this very fragile child that cannot defend themselves, and u- until they start talking, they cannot communicate really with anybody but you.
I mean, other- Yeah people in their life, you know, uh, the second parent, the dad, you know, can communicate with them.
Grandparents kinda have a low-level communication with them.
But your primary communication with that baby is that mom.
And so, yeah, you're right, it is it's a lot.
It is something that I have really noticed really heavily, and I actually think, until this conversation, I don't know that I've realized how intense it has been, but it does impact every single moment of every single day.
Or for me it does at least, because you're right, this baby is 1,000% dependent on you Yeah, there's this intense hypervigilance, and I do it too.
I used to, I used to jaywalk no problem, and now I'm like, "Oh, mm-mm, I'm gonna crosswalk.
I'm gonna wait."
Like, yeah the level of precaution that I take now, um, I don't know if it speaks to how careless I was to begin with or how...
But that like, just like I'm like, "Okay, no, I can't do that.
That could hurt the baby.
No, we're not gonna do that."
I was someone that, like, would go cliff jumping or things like that, and now I'm like, "Ah, I can't.
If something happens to me, he's not gonna be okay."
Like, there's a, yeah, a lot more responsibility, and I think then our brain picks on that, and it tries to take all those pieces and the...
and it, for each of us individually, depending on what our stressors and vulnerabilities are and e- and even our insecurities, that's where it chooses, I think, to...
Or what we're hearing in the media or the news, it's like, okay, this is the big threat, and then we're primed.
And I think sometimes an important piece is that compassion you were talking about going into the bank and, like, very aware of your own biases, and I think that's something I sometimes struggle with, is I'll go into places, and I'll get anxious How can you be so, like, calloused or so biased or be stereotyping like that? These are probably nice people, and then I have a war between, like, my, my fear for my baby and my recognition of how I've come to have these biases and how unfair they are.
And I think it's important for people to hold both, and to have that awareness that, yes as you did, like, this is probably a bias, and to have compassion for themselves rather than judgment that they're having that because I think that gives more space to have a reaction that feels good for you and your baby, and that's still kind of mindful of the others around you, and yourself for having that.
I don't know if anyone else has that, but I, I definitely notice I have that kind of war maybe inside my head.
For sure.
I think there's constant war.
So, you know, I have the same thing.
It's like, that person's probably a very nice person.
They're, they're just wearing something that sketched you out.
But then, on the opposite end of that, you're like, but all of the gun violence in our country, and all of the mass shootings that we experience, I'm sure everybody that saw that person that day probably did the same thing you and I do, and we made excuses, and we were like, "Oh, they're probably a very nice person.
Just because I wouldn't wear that in the hot summer sun doesn't mean that person can't wear it."
And then it ended up being a tragedy.
So where I have landed is there are seasons in your life, and this is a season where I am not...
I would never hurt someone or, you know, call someone out.
Mm-hmm.
But this is the season where I am gonna be hypervigilant, and I'm okay with that, and it does mean that maybe I do weird things.
Like, instead of going to wait in the waiting part of the bank, I go and wait by the door.
Yeah.
And it's okay if people are like, "She's being so weird."
For me, I'm like, "Yep, I'm being weird."
I'm also, I'm working with my nervous system here.
I'm keeping my child safe.
Mm-hmm.
I am not spiraling, and I'm able to accomplish the goal of getting whatever I need to notarize, notarized in a way that feels good to me, that doesn't compromise or impede others.
The other war, you talk about wars, you know, and I said there are constant wars.
The other thing, and I've talked about this on the podcast, and I talk about it online too, and this is not new in pregnancy or postpartum for me.
I've had this growing as we've seen gun violence grow in our country, my anxiety in crowds have, has grown alongside that.
And even before I was pregnant, even before we had Saggy- I had this increasing anxiety going into big crowds.
Concerts, fairs you know, community days.
Mm-hmm.
Anywhere that there were large crowds accumulated, there was always this low level anxiety of, of, like with me of Where would I go and what would I do, what would the plan be for me and my husband- Mm if something broke out while we were here at this place? And- Mm-hmm it has become much more intense now that I am a mom.
And when- Yeah when we first had Saggy, it was really overwhelming.
Actually, I, I avoided big crowds and, um, when we went to places like malls and stuff, I really couldn't relax.
It was not an enjoyable time for me, um, because I felt like I was always having to just be on guard, right? I was always- Mm-hmm looking to make sure that our immediate area was safe.
I was always looking for the exits.
I was always looking for, what would we do if something bad broke out? Yeah and you know, I think part of that is postpartum, and I think part of it is just living in the world that we live in today.
And accumulated on top of that is living in a country that doesn't have very good gun laws.
And you know- Mm-hmm we can look around and just realize that we're not safe in our country when it comes to gun safety, that, you know, people do get access to weaponry that they just shouldn't have access to.
And then, you know, obviously there's violence with that.
And I do think that those internal wars can be really hard because so many of us, and I genuinely believe this, so many of us are good humans.
I believe that the majority of humans- Mm are good humans, and you want to be a good human.
You don't wanna judge other people.
You don't wanna say, like, "That person is dressed weird, so they probably are a school shooter."
Like, you don't wanna be like that.
But then- No you also have this insanely protective feeling to protect this newborn.
Yeah, you're rubbing your baby right now.
I, like, wanna go down and grab Saggy and, like, give him a kiss.
It's instinctive.
Yeah, it is.
It, it's just this, like- Yeah it is just guttural, it, that you would do anything to protect this baby.
And for me, that sentence goes, I would do anything to protect Saggy, even if it means I need to judge another human.
Um, and, and I hate- Mm-hmm that.
I, I never wanna be a judgmental person, but if it means that I have to hurt someone's feelings or I have to unfairly judge somebody in order to keep my child safe, then I will, right? Like, I just will do that.
I will leave the mall.
I will go stand by the door at the bank.
I will- Mm-hmm you know, park on the outside or the, the outer part of a big parking lot at a concert to make sure that we can get out first.
Like, there are just- Mm-hmm things that have completely changed in my brain, like my brain chemistry.
I can just feel that my brain chemistry is literally different.
I'm so glad you brought that up because you're right, it is a constant battle in the brain about like, I don't wanna judge that person, and like, wow, that's super unfair to think that of that person, and also coexisting with that, two truths, I wanna keep my baby safe, right? I wanna be vigilant.
I wanna keep my head on the swivel.
I want to recognize danger before it is right in our face.
I want to be able to get out of a compromised situation.
Um, and I, I think it, I think it's really helpful to hear that, A, that's normal, and B, that we're not alone.
Um, because when you're having that battle in your head, oof, it's really easy to be like, "Wow, am I crazy? Like, am I cuckoo bananas? Should I be living in a psych asylum instead of my home?" Because yeah, it feels...
It does.
It feels just really unsettling.
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I cannot wait to see you in there I have a question about your OCD.
Does your OCD show up the same in postpartum as it did pre-baby, or have some of your symptoms changed? I would say that it was pretty well managed.
Like, I don't think I would've been at clinical levels by the time I got pregnant.
Uh, eh, having said that I've had various forms with it, so I did notice that immediately postpartum I was more likely to want to check the stove twice.
Things like that got a little bit more intense.
As they always do any time I have a transition, any time I have a stressor, I notice the urge to do those sort of repetitive checking compulsions uh, show up a little bit more.
I would say my OCD has always been quite sneaky.
So it's not...
It's always been more of that obsessional ki- like the yes, I gave the stove example, but often it's more I'll have a thought, actually kind of like, the one of the ones I had in pregnancy was of losing the baby losing the pregnancy and having a miscarriage.
Um, and it was quite visceral, like I could imagine the blood, I could imagine the feel, like, like anyone.
And my brain twisted that to say that that's what I wanted.
"Oh, maybe I actually secretly want a miscarriage because I don't actually want a baby."
Is...
And it made it twisty.
Now, for reference, I was someone that was basically crying every time any friend shared that they had a pregnancy for about three years, because I so desperately was waiting for me and my partner to be ready to have a baby.
So I very, that was a very ego dystonic thought.
It was, it was the exact opposite.
It was not ego dystonic, so just means the opposite of who you are and what you believe and what you want.
But my brain was like, "Oh, well, this is what you secretly want."
And it would use things like the fear I was feeling about how our life would change with baby as evidence for why I secretly wanted this to happen.
It would use things like the grief I was feeling about the way life would change as evidence, or the kind of the heaviness I was feeling about the responsibility, like, holy crap, there's no way to go back.
Like, there's no going back now.
I I mean, I, in Canada, there is a way of going back, but for us and what we wanted, there was no way.
W- not, wasn't an option for us 'cause we didn't want to.
Sorry see, it's already making me twist up my words.
But it used...
So that part of my brain that makes me doubt myself, that makes me get stuck in compulsion, kind of made this, like, really weird, twisty that left, that internally was like y- yeah, wanted me to kind of doubt myself and leave me frazzled.
I would say that it didn't impact me as much as a thought like that would have prior to getting pregnant because I had done so much work on my OCD, so I recognized it.
Immediately I was like, "Most likely this is just OCD.
And if it's not, well, then I'll live with it."
Kind of like a mini exposure.
And I did, one thing I did do, I think I did a, um, it's called a neutralizing behavior when you have an intrusive, like a bad intrusive thought, and you then go like mentally say the opposite.
It's a type of compulsion.
It's a mental compulsion.
And then I would rub my belly, and I would say, "Well, Mommy loves you.
Mommy really wants you."
And so technically that was a compulsion.
It's a neutralizing behavior to cancel out the bad thought.
And if that, if I was starting to do a whole bunch of other things, if I was For me, and this is my own personal assessment of where I want to be in my OCD journey to me that was a reasonable amount of compulsion because- Because it was.
Because it felt right, and it didn't, it didn't impede my life.
It didn't int- like, my thoughts didn't get worse and worse and worse.
I didn't have more wondering.
I didn't go out and start doing other compulsions like confessing my fears to people or my bad thoughts seeking reassurance to make sure, no, this, you do really want this baby.
This isn't, like, anything like that.
I didn't...
It didn't escalate.
So that's maybe something that has been different in pregnancy and postpartum, is that I I allow some things that for my more traditional forms of OCD I would put a stop to because they could become compulsive, but I've given myself more leniency in pregnancy and postpartum recognizing how intense this period is.
And unless I start to notice that whatever behaviors I'm doing mentally or physically are closing me off and making it so that my life is getting smaller and smaller and smaller then I allow myself a little bit more compulsion.
Hmm.
Hopefully that makes sense.
Yeah, it does, and it's so interesting to hear you share about your experience because I think together you and I depict a really beautiful spectrum.
So, and I've shared this on the podcast before, and I shared it online I was super scared when I first got pregnant.
Not of pregnancy- Yeah not of having a baby, like birth, right? I was so fearful of how my life was gonna change.
It So I- I'm on one end of the spectrum, because it, it was the thoughts, but it never led to any compulsions, and it didn't never escalate into me visualizing a miscarriage or losing the baby or even my brain saying those tricky things about like, "Maybe this is what you want."
And on the opposite end of the spectrum, you had that.
And I think it's a really beautiful depiction that these aren't gonna look the same for everybody.
They're gonna look different, but it's all normal.
Like, these are things that a lot of women and mom experience when they get pregnant or throughout pregnancy even though, I mean, this may be your first conversation that you're hearing people talk about this, you guys.
Uh, and people just don't talk about this, because I think there is that level of shame and embarrassment and, you know, should I be feeling this, and should I be thinking these things.
And I think it's, it's really normal.
For me, I did very similar things to you.
I would just say, like Life changes, and I've always been able to swing with the punches and, and this is gonna be different, and I will figure it out.
And, you know, I would remind myself, like, we were always going to have kids.
Maybe we weren't planning on this moment to have children, but what's the difference between now and next year? And, you know, you've gotta find mantras and things you can tell yourself that feel good to you.
What, what works for me probably isn't gonna work for you, and it may not work for the next person.
But finding, I think, those things that you can tell yourself to reassure yourself, kinda like you did.
Like, rub your belly and say, like, "Nope, Mommy loves you and I wanted you, and I'm so excited to meet you whenever you're ready.
And you're strong and healthy, and Mommy's strong and healthy, and we're working together."
Like, just really kinda talking yourself down or off that edge.
Is that how you would describe that? Y- yes and no.
I think because, because of my history with OCD, reassurance is a really tricky one because reassurance can turn into a compulsion.
So let's say someone, someone has the thought "What if I put my baby in the blender?" And I'm using that one because it was in one of the studies I read, and it's, like, a really poignant one.
But someone has a thought of that nature.
And then they start going, they start going to their partner, "Oh, do you think I'm a bad mom? Do you think I could ever do that to our baby?" Um, and then the partner goes, "No, of course not.
No, you can't."
And then but that doesn't alleviate the fear.
And then they're like, then they go to their parent, "Oh, do you think I could go do that?" Or...
And it just becomes the more they seek reassurance, the more they f- they...
It becomes th- they stop, they don't believe that and their brain is like, "Oh, but maybe you could," or, "Maybe your partner doesn't really know you."
Um, or maybe then they start doing self-testing behaviors where they're visualizing or they're scanning their body, "Oh, do I have an urge to actually do that?" And then as they're scanning, of course, they're anxious, and they're thinking about that happening, so their body is getting, having a physiological reaction which in their stressed state they're potentially misinterpreting.
Or then they're going to research, how likely is it that someone would do something like that? That's, this is where it's kind of moving away from just an intrusive thought, and now you've got the follow-up compulsion to try and get rid of and stop the thought.
That's where I would be really cautious about reassurance, to say, "Hey, you're not gonna do this."
Oh, you're okay, buddy.
"You're not gonna do this," if it's gonna escalate into more compulsions.
Because that's now gonna feed the OCD cycle, and the thoughts and fears are potentially going to get worse.
So in a situation like that I, I would use more of an encouragement or a reassurance that's, like, a, that's not saying, "No, you're not gonna do this," but more of a, I trust that, or more like a You can handle this risk.
You can handle this risk.
You can handle this uncertainty.
You can handle this doubt.
You are strong.
and if it is escalating to that extent, I think it would be important to get more more specific OCD postpartum support.
Um, but even...
And it's easier to imagine in something like if you're having intrusive thoughts of falling down the stairs, and you've asked for reassurance, "No, I'm not gonna fall down the st- No, you're not gonna fall down the stairs.
You're gonna be okay."
But then you get more and more worried.
You're starting to avoid the stairs.
You're adjusting how you go, like you're going down the stairs backwards.
There I would use almost like a mini exposure reassurance to be like, it's unlikely to happen, but if it does, you will survive it.
You will get through it.
Even if the worst happens, you will get through it.
You can handle it.
So you're not necessarily telling someone that they're not, that the thing they're scared of isn't gonna come true, you're saying you can handle it.
I don't think it's gonna happen, but if it does, you can handle it, and I am right here with you while you try this thing that's important to you in spite of the risk.
It's kinda like when you get into a car, someone can tell you that there's not gonna be an accident But- But you know, there might be there might be.
Yeah.
Yeah.
And you're taking the risk anyways.
You don't want there to be an accident.
You're gonna do what you can to prevent it, but you are, you can survive the risk.
Or you can, you can handle the risk.
You are strong enough to handle the risk of this happening because you have the tools that you need to do what you can do within your power to not let that happen.
Mm.
But there is still a risk, and you can handle that risk.
It's really interesting to hear you say that because as I kind of walk this path and I, I don't have OCD.
I just want everyone listening, like I, I don't have OCD, and so I don't think you need to be diagnosed with OCD to, to experience some of this low level stuff.
And for me, it's really interesting because that's kind of my natural instinct.
I tell myself...
So go back to the bank ex- experience.
The guy walked in.
In my brain, I clocked him as potentially a danger.
I did what I wanted to do immediately.
I moved Saggy in front of me.
I put space between Saggy and the person.
And then I was thinking, "All right.
I'm not gonna leave the bank because I came here with a goal."
It's also unlikely that this man has any nefarious intentions, right? And so I'm, I'm weighing these risk.
But what can I do in this moment to settle my nervous system and also kind of stack the cards in our favor if something were to happen? And for me, it was just waiting by the door.
And then from there, I just kept an eye on that guy and, and you know, he had his hands in his pockets the whole time.
Obviously, that was tripping up my thoughts.
I was completely just imagining what he had in his pockets, and then that would make me imagine certain scenarios.
And in, in my brain, I was almost like, I was almost like doing what football teams do to practice.
I was running through certain scenarios and like, what would I do in that scenario? How would I get Saggy and I out, right? I moved my cell phone from my back pocket to my hand.
I- Mm-hmm moved us to the door.
I put Saggy in a position that I could hold him with both hands and run out the door, right? Like, in my brain, I was kind of- I guess role-play in a little bit to think- Mm-hmm through like, all right, if something were to happen, recognizing that it's unlikely, very low chance, but what would I do? Um, and so for me that was helpful.
What other tips do you have for people who are maybe e- experiencing some intrusive thoughts, and maybe they do have a diagnosis of OCD? I would seek support, um, first off- Like professional support? Y- yes, professional support from someone that is trained in OCD ideally OCD because there's a pretty high The studies that have been done, there's a pretty high percentage of misdiagnosing OCD and and postpartum OCD.
Something like, I think the ranges are, like, between 30 and 70% misdiagnoses across different professionals.
These are, these this is based on data from 10 years ago, so it probably is improving.
But seek out someone that has both experience, that has that knowledge.
I think having that perinatal experience is really important, too, because I, I really think that, a lot of OCD specific treatment is very ERP focused, so exposure response prevention and it can be quite manualized.
There's other things like ICBT, acceptance and commitment therapy, that are also really good complements.
But I, I think that the postpartum and perinatal period in general requires a very maybe sometimes a gentler approach, maybe a little bit more flexibility.
So keep that in mind.
And get the support of your family.
Every personally and clinically where I have seen people have the most success is when their family members are on board on the treatment, and the family members are aware of the compulsion.
Because really most of the work is gonna be within that family support unit.
And you may be inadvertently making symptoms worse.
Um, but I would also, What I would do, whether it's OCD or just intrusive thoughts that are upsetting I find it really helpful to externalize them, like actually give that I call it my OCD, but it could be, like, give it a persona, uh, my worried part, my intrusive thought part.
Like, uh, maybe make it a character or a scared puppy.
And it's something, uh, some people make it a monster.
I would- caution against making it a monster or if it is a monster, a lovable monster, 'cause it needs your compassion and your support.
It's just scared.
So it needs, it's the same way that you show up for your baby when you hold them and you're like, "Hey, I know this is scary.
I know you don't understand.
It's okay.
Mommy's got you.
We're gonna do this together."
And really, you're almost talking to that part of you that's scared, that's scared to go down the stairs, to say, "It's okay.
Mommy's got you.
We're gonna do this together.
I know there's a chance you might fall, but we're gonna do it together.
We're gonna take it one step at a time.
You've got this, and if you fall, I will catch you."
And in that sense, it's almost like a metaphorical, like catching yourself.
If you make a mistake, a little bit, I will catch you.
And I, I think, so that's one where I would.
Another thing I would do is kind of start naming the thoughts.
I'm having the thought that I could do this.
I'm having the thought, what if this happens? I'm having the thought this could happen.
Sometimes even doing, like, a full dump onto a page where you can write it out all as a throw-up of all the thoughts that are happening, and then separating out.
Sometimes that can that can show you how many coulds have to happen for your thing to be true.
And you're like, okay, well this was, Like, let's say you have a fear of contamination.
What if my baby comes into contact with HIV? And you're at the restaurant, and you're like, "This could have happened maybe because possibly my baby is playing on a blanket, and someone stepped on the blanket, and maybe this person who stepped on the blanket could have been walking down the street somewhere where someone could have been using a needle that c- and that person could have had HIV, and it could have been on the needle, and that could have been on, like could have gotten on the needle, and that could have made it on the blanket."
Like, the logic there is pretty y- It's a stretch Like- It could happen, for sure.
It's a big stretch.
But it, the likelihood is very low.
Very, very low.
You're probably more likely to be hit by lightning.
Yeah.
But your brain has now made that stretch, and it's, like, logic-ed your way to it.
And so now if you're not gonna let your kid play on that blanket- That's almost like not letting your kid play outside because they might get hit by lightning because it might start lightning without warning maybe, and at that point you're probably closing your life off.
And if when you write down the thoughts and you write down how you came to that not in an analysis way, but then you get some separation and then you're like, "Okay, I can practice taking this risk," because it is gonna feel like a risk to the person that's having that intrusive thought.
That's when I like the breath where you're like And you blow out for six to eight seconds.
The long blow out is important.
I had a therapist teach me that once.
It's my favorite go-to.
And also, like, moving your eyes and just kind of, same therapist, kind of looking around to focus because when you get really into that imaginary land you kind of, you go inwards, and you kind of just kind of shut down.
So coming back into the present, five things you can see, four things you can hear, three things you can touch.
Those can be really helpful.
And then I would practice doing mini mini values-based exposures.
So let's say your fear is contamination and your child getting sick.
Well, don't go to a restaurant and put down a blanket and let your baby play.
That's maybe too far.
But maybe you start with a close trusted friend, and you let your baby sit on their couch.
Maybe you move from your inside clean place to your backyard, and you do it for five seconds, and you take these teeny tiny little baby steps throughout without and then you're watching for the s- for any things, any kind of, like, additional safety behaviors that you're doing, 'cause you're wanting to do it without the safety behaviors, which could be things like I don't know, sterilizing your friend's couch before you put your baby on it.
It could be washing your baby's hands immediately after they come inside.
And those, the things you choose to do are gonna be different depending on the person.
I think everybody has to decide for themselves what level of, especially with a child, what level of caution works for them and is enhancing their ability to fully live their lives and give their baby a rich life, and I use rich not in financial terms and what is closing them off.
That's so- That was a long answer.
Sorry interesting.
Yeah, that's so helpful.
I never, I never even thought about, you know, the more what can feel like protective measures that you put into place, right? In the moment, you're like, "Well, I just won't do this- Yeah 'cause I'm protecting my baby."
But if we do too many of them, you actually are then closing off your life.
There's a fine balance of keeping yourself and your baby protected, and also not impeding your quality or your richness of life and experiences.
I never even thought about that.
So, you mentioned that postpartum OCD is often misdiagnosed.
What kind of diagnosis are we seeing that might be misdiagnosis? Is it things like postpartum anxiety and depression, where really this person has OCD, or is it something different? Those are some of them that were cited.
Um, the other one that sometimes, And I'm hesitant to even say this because I do not want people to not seek out support.
Mm-hmm.
Um, but the, I think when the intrusive thoughts are of intentional harm, there is a potential for the, the provider needs to be aware that this is a normal part of postpartum.
Yeah.
Because I think people don't report or disclose those types of thoughts because they're scared that a child would be taken away, or that protective services would get involved.
There are no stats on how often that happens.
I'm just looking at my notes here.
My hypothesis is that the most likely misdiagnosis would be things like anxiety, depression.
There's some overlap potentially with psychosis.
Not, and I'm not saying there's an overlap.
I'm not a diagnosis I don't diagnose.
But that would be something where I guess there could potentially be a risk.
Yeah, so, uh, the 2020 study based on 2017 survey found that 70% of 94 medical professionals misdiagnosed postpartum OCD, and I think the most common were both uh, anxiety and depression.
And part of that could also be how, in screening tests what kind of questions are asked, because most people don't, might not recognize that thoughts of harm either coming to the child accidentally or intentionally, um, could be are intrusive thoughts.
They might not recognize those as actual intrusive thoughts.
And because some of these compulsions are so sneaky, like these safety behaviors or protecting the child or kind of neutralizing, um, and self-scanning they just feel, like, normal.
And that was actually You had asked me earlier how it differentiated in post- like how my OCD was different.
Some of the things I was doing felt really normal, like some of the level of cleanliness, some of the, like, cleaning, some of the, like, not letting him go there, here or, um, some of that.
E- eventually I was like, "Okay, this is a bit too much," and I recognized that I was maybe doing compulsions rather than just being cautious, but that's a, that's a fine line and it's gonna differ from person to person.
But I do think despite the numbers that I just gave, I think it is really important to talk to someone that you trust about these thoughts.
Remember the stat that I gave you at the very beginning.
Moms who report intrusive thoughts, including intrusive thoughts of intentional harm to a child, are based on the data no more likely to harm a child than ones who do not.
If an- and based on the numbers that were given, they were slightly less likely than a mom who doesn't have the thoughts to harm their child.
And I think that's important for both support people and the person that's having it.
So ask for help.
Look for someone that has this experience.
Google postpartum intrusive thoughts to get a sense of normal.
If you find that you are googling and then you're like, "But what if maybe I'm this or I'm the exception?" Or you see something online that, like, I don't...
There's a study that compares intrusive thoughts and psychosis.
If you land on a study like that and your brain's like, "Oh, but maybe I'm in this one category.
Could this be possible maybe?" Be like, "Okay.
Thank you, mind."
Thank you.
I appreciate that fear.
We will get through this.
This is most likely not true, but if it is, I will survive it.
Mm-hmm.
And try not to go down that path of now using the research that you just did to reassure yourself that you're fine as more ammunition for your fear.
And this is where I think someone with intrusive thoughts, they're gonna re- just intrusive thoughts, they're gonna read that data.
They're gonna be like, "Okay, whew, good."
There's ma- there's gonna be a level of easier to navigate the intrusive thoughts.
If it's going into OCD range, you're potentially now gonna use that reassurance to create further doubt, and that's when you need to take the step to get more specific OCD-type help.
Mm, yeah.
Oh my gosh, this has been so, so helpful.
I love the little spiel that you gave right here at the end.
I think that's probably the most important part for our healthcare workers to hear.
Um, I think that probably a lot of the misdiagnosis comes from healthcare workers just not having access to this information, not having training on what these different postpartum complications look like, how do they present.
I think a lot of times, you know, our OBGYNs and our midwives and our, our hospital staff, our, our medical birth workers are typically trained to hand that off to a psychiatrist or some sort of psychiatric worker and I think that you know, in, in this country particularly, we just don't have enough resources, especially when it comes to mental health.
It's not something that we fund.
It's not something that we prioritize.
It's not something that we talk about.
And we have a lot of things in this country that harm our mental health without any sort of, uh, rules or boundaries or, um, you know, safety features, primarily social media and video games and mommy culture.
I just think there's so many things out there that, that can harm our mental health and- Yeah um, and make it really hard to be a mom.
So thank you so much for sharing your story, for sharing these stats.
Um, we can link that study that you had referenced- Yeah in the show notes.
I think you did a really great job of showing the spectrum.
What is normal? Let's normalize that some of this is just transitioning to be a mom, but then there is a place on that spectrum where it kind of transitions into something that maybe you need a little bit further support on.
And, and if that's you, there's absolutely no shame in getting support.
Actually, it's one of the strongest things that you can do is ask for support.
Bring your family into it.
Help your partner understand what you are experiencing so that they can now support you, because I love what you said, you're just scared.
There's just a piece of you inside of your brain that is really scared and on high alert and maybe stuck in a hypervigilant mode that they just wanna protect you and your baby at, at all cost which is not a bad thing.
That's like every mom- No on earth wants to protect your baby at all cost, but I think, you know, sometimes it does go beyond, um, it does go beyond maybe what is functional, right? Um, so- Mm-hmm if you're out there and you're listening and you are feeling like you want support, Špela, how can people connect with you? How can they learn from you, work from you, and are there any general sites that people can go to? For one, I know Postpartum Support International, but are there any other resources that you want people to know about, uh, in order to seek support for things like this? Yes, absolutely.
So if you wanna connect with me, you can find me at Špela Grašič Counseling on Instagram.
I don't have a website yet, so you'll find me there.
If you're in BC, um, British Columbia in Canada, or in an unregulated Canadian province, you can also work with me from a counseling perspective.
Clearly, based on this blurb that you see, or blob I have limited availability at the moment.
But you can reach out.
I would also...
The International OCD Foundation has some great resources on their website, including a list of providers.
The international iCBT foundation as well has some really, I think, good content.
It's a different way of treating OCD, but it's, it's one I found helpful and I use pieces in my clinical practice.
I also liked acceptance and commitment therapy.
There's a online program it's called The Happiness Trap, that you can use.
Um, there's some stuff there on thought diffusion, separating from your thoughts, creating distance, that I think is really, is really helpful and it's, it's great tools for intrusive thoughts, whether you're just having them kind of ad hoc or if they're kind of going into OCD realm.
Um, and it's p- it's...
if, if budget is a constraint, that's something that's potentially a little bit more accessible.
Another, uh, Instagram account that I really like is anxietyocdtreatment, and she's based in the States, I think, so potentially more accessible to your audience.
There's some really great graphics on that account that explains OCD, the different types of treatment, supports for loved ones.
It's not postpartum specific but I think it's a good tool for sure.
Thank you so much for being here.
Thank you for sharing your story.
Thank you for sharing the normalcy of this, and also maybe what's a little bit outside of normal, and also where we can seek support, how we can bring our family and our partners into this experience, and how we can start to make this a little easier because being a mom is hard.
Being postpartum is, is not easy, but we're all out here doing the best that we can.
So Špela, thank you so much for being here today.
And you guys, I'll see you in the next episode.
Be sure to follow Špela on social media.
And you can find me at tranquilitybyhehe and at the.birth.lounge.
Until next time, head to your app store and download the Birth Lounge app for evidence-based childbirth education and data-driven postpartum support delivered straight to your phone.
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