Yield2Yin

A Therapist's Advice

A Yield2Yin Approach to Life by Sara Cloostermans, MA, LMFT, LPCC

Thoughts, Feelings & Behaviors

My Postpartum Experience: How I Survived Postpartum Depression and Anxiety

by Sara Cloostermans on category ,

“There were others!”

I thought as I cried tears of relief while reading the stories of two other mothers who had similar postpartum symptoms to the ones I was dealing with. Before that moment, I had no idea perinatal mood and anxiety disorders (PMADs) even existed, let alone what they looked like. So, there was zero chance that I would have been able to recognize the multiple warning signs (as obvious as they may have been) within myself.

This was 25 years ago – I was completely unaware not only because I had never experienced the inner world of someone with mental illness, but also because it was 1998. Back then, there was a total lack of postpartum health education, and even had there been some, the internet was hardly available to the public, so quick and easy access to information was very limited.

There I was, 27 years old – deep in the trenches of postpartum depression and anxiety, and also dealing with an undiagnosed (and misunderstood!) case of postpartum OCD – terrified that I had turned into a crazy psychopath, and wondering if my baby and I could even coexist on this planet. And though my husband and I had (and still have) wonderfully supportive families, we were living alone in Berlin, Germany, as expats at the time, so reaching out for support was complicated, with my husband’s family being settled on the East Coast of the US and my family residing in Belgium.

My journey of healing and recovery ended up being long and hard. But in the end, it led me to finding a career I am passionate about to this day – a career as a therapist working with other parents coping with PMADs. It also led me to being bold enough to have another child 6 years after the birth of my son T., a baby girl in 2004, through open adoption.

This is my story. I’m sharing it with you because it may stand as a “There were others!” for you too (or for someone else you may know who could benefit from my story somehow.)

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Postpartum Mental Health 101: Postpartum Depression, Postpartum Anxiety & More

by Sara Cloostermans on category ,

Not very long ago, the way women felt in their minds and bodies during and after pregnancy was entirely hush-hush – considered private, and at times even shameful. Many women were drowning, and nobody was paying attention.

Luckily, the tides are changing, and our culture is warming up to the idea that talking about postpartum health – especially postpartum mental health – is essential for healthy moms, healthy babies, and a healthy society.

Yet many of us aren’t well-versed in the various ways a mixture of hormones and experience (past trauma, recent loss, bad marriage/partnership, lack of social support, incl. return-to-work support, etc.) can shape a woman’s mental health during pregnancy and postpartum.

So, consider this article your guide to Postpartum Mental Health 101.

It’s a must-read for anyone who may become pregnant, is pregnant, is postpartum, was postpartum… and for anyone who knows a woman who falls under any of these categories. In short: everyone can benefit from this info!

“Postpartum” or “Peripartum”?

Most of the time, the word “Postpartum” refers to mental illness that begins AFTER DELIVERY of the baby. However, due to hormonal changes, and adverse past or current circumstances, pregnant women can begin experiencing mental health symptoms DURING PREGNANCY.

A broader term encompassing both the postpartum period AND the pregnancy is therefore more accurate: “Peripartum” (or “Perinatal”).

When Can You Experience Peripartum Mental Health Illnesses?

Every woman’s experience is different. Typically, if any of these disorders show up during pregnancy or within the first 12 months after delivery, they are considered “Peripartum” or “Perinatal”. They are now commonly referred to as “PMADs” – Perinatal Mood and Anxiety Disorders.

Some women experience a PMAD during their pregnancy, and others within the first couple of weeks or months after delivery. Still others don’t begin to display symptoms until after their babies are already walking. For some women, the sudden hormonal shifts of weaning can also trigger a type of PMAD.

What Are the Seven Types of Perinatal Mood and Anxiety Disorders (PMADs)?

  1. Baby Blues
  2. Peripartum Depression
  3. Peripartum Anxiety
  4. Peripartum Obsessive Compulsive Disorder
  5. Peripartum Bipolar Disorder
  6. Peripartum Post-Traumatic Stress Disorder
  7. Peripartum Psychosis

Note: in the DSM-V these disorders are not all classified as either a “mood” or an “anxiety” disorder (or not recognized at all as with the baby blues); yet, for the purpose of simplification, all 7 disorders are listed under the same title.

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demystifying psychotherapy

Demystifying Psychotherapy

by Sara Cloostermans on category , ,

If you’ve never been to therapy before, the whole experience may feel like being the new kid at school … or the new hire at a well-established company … You don’t know who everybody is, where to go, how things operate, where you should put your bag, or if they’ll be nice to you at lunch.

This blog serves as the sidekick to show you the ropes. We’re demystifying psychotherapy. What therapy is. Who you can see. The types of sessions to expect. The goals.

Here are two things to realize up front:

First off – the taboo nature of going to therapy greatly decreased amid the pandemic – more people from across all demographics are accepting the idea that, just like we should see physical health specialists when we have physical health concerns, we need to see mental health professionals when we have mental health issues.

Next – therapy is for everyone. Not only for people who are on the brink of divorce or people who have experienced trauma or have other forms of mental health concerns. Every single human being benefits from therapy in the same way everyone benefits from checkups at the doctor or regular exercise or a healthy diet. It’s an act of self-care.

What Is Psychotherapy?

Psychotherapy is a type of therapy that helps people who are facing mental health challenges improve their overall well-being. By far the most common client complaints therapists come across are clients being impacted by symptoms of depression and/or anxiety (at various levels of severity).

Why Go To Therapy?

Here are some of the most common treatment objectives in psychotherapy:

  • psycho-education (for example, someone experiencing anxiety learning about the sympathetic nervous system, or fight/flight/freeze/fawn response, and the parasympathetic nervous system, aka the rest and digest response)
  • emotional regulation (breathwork meditation, progressive muscle relaxation, validating feelings, compassionate self-care actions, self-soothing talk, etc.)
  • stress reduction and improved coping skills (yoga, journaling, exercise, socializing, calming music, dance, art, nature activities, etc.)
  • trigger identification – ask yourself: “What started or worsened my symptoms?” (incl. trauma triggers with PTSD)
  • behavioral changes (time management, bedtime routine, environmental changes, rewards, etc.)
  • cognitive work (awareness of thinking errors, cognitive restructuring, coherent and constructive narrative of one’s life story)
  • improved communication skills (active listening, paraphrasing, being mindful of non-verbal communication and tone, assertiveness and boundary skills, etc.)

How Do I Choose My Therapist?

Look for someone who is credentialed to provide psychotherapy (and ask them about their clinical expertise):

  • Psychiatrist, M.D. (doctor of medicine who specializes in psychiatry)
    • Can they prescribe medications? – yes
    • Can they administer and interpret psychological testing? – a psychiatrist will refer you to a psychologist for psychological testing and to a neuropsychologist for neuropsychological testing because they are the ones who are expertly trained in these areas
    • Can they teach at college level? – a psychiatrist is more likely to teach students in medical school or psychiatry students doing their psychiatric residency than to teach students in a psychology program; a psychiatrist can also be a guest lecturer on topics such as anatomy or physiology in other health science graduate programs.
  • Licensed Psychologist – Ph.D. or Psy.D. (they are NOT medical doctors, but have a doctorate degree in psychology)
    • Can they prescribe medications? typically not, but in certain states, they are allowed to prescribe psychotropic medications with additional training (not in California)
    • Can they administer and interpret psychological testing? – yes
    • Can they teach at college level? – yes, they can teach students who are obtaining a doctorate degree in psychology as well as master’s degree and undergraduate degree students with a psychology major
  • Licensed Marriage and Family Therapist – LMFT (master’s degree)
  • Licensed Professional (Clinical) Counselors LPCC or LPC – (master’s degree)
  • Licensed Clinical Social Workers, LCSW – (master’s degree)
    • Can they prescribe medications – no
    • Can they administer and interpret psychological testing – no
    • Can they teach at college level? – yes, they can teach students who are obtaining a master’s degree in their same field as well as undergraduate degree students with the same major (marriage and family therapy, social work, and counseling respectively)

FYI – a life coach has no formal education in psychology and is not licensed to practice psychotherapy.

Look for some of or all of these 10 traits when screening different therapists during your initial phone call or your first/intake session:

What Are The Different Formats Of Therapy?

There are four different formats of psychotherapy (individual, group, couples, and family) and each format has several different approaches (aka orientations, theories, or schools of thought) to therapy – with each format, I am adding a list of five different approaches to therapy, but the number of approaches listed below is not exhaustive. Keep in mind that the same therapy approach can be used in some or all of the different formats.

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How To Be More Generous

by Sara Cloostermans on category , ,

Here are two things people often get wrong when it comes to generosity:

  • Myth #1: Generosity is all about money
  • Myth #2: Generosity is a trait of the well-resourced only

The truth is generosity can of course relate to money, but it is also about acts of service, time, and attention.

Furthermore, generosity is an attitude, a personality trait. It is more about your relationship with money, with your career, and with time and attention than it is about the amount of money you make, your daily to-do list, and the amount of time and attention you have available. It is about what you value and what you prioritize.

Just like we have a relationship with people, we have a relationship with concepts as well. Not only with concepts such as our money, the action items on our agenda, and our time and attention, but also with many other concepts, such as food, alcohol, exercise, social media, and so on.

  • Are your relationships with your money, your to-do list, and your time healthy or unhealthy?
  • In other words, do you have a healthy attachment or an unhealthy attachment to these 3 concepts?
  • Are you securely attached or are you anxiously attached to your money, your to-do list, and your time available?

Let’s break down these forms of generosity and some common blocks people have from fully stepping into a generous spirit.

Financial Generosity

It is not because someone has more money that they are more generous with their money. More resources does not automatically mean more generosity. For example, just because somebody has a lot of extra time does not necessarily mean they exercise more than somebody who is often crunched for time.

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life is unfair

The Duality of Life: Finding Empathy and Meaning When Life Is Unfair

by Sara Cloostermans on category , , ,

Around this little corner of the internet, we often discuss the yin and yang of life. The light and the dark. The joy and the pain. The go-go-go and the slow down. We’ve seen how these yin and yang forces are more complementary than opposing. 

This same concept brings us to a reality of humanness—the duality of life, I call it—which can look like this:

The worst day for someone can be the best day for someone else.

  • One family loses their dream house due to a foreclosure. That house goes on the market and becomes another family’s dream house they otherwise couldn’t have afforded.
  • One man dies and his heart is donated; one man lives because of that donated heart.
  • One woman places her baby for adoption; another woman is finally able to have a baby because of the first woman’s adoption placement choice.

Throughout our lives, we will be on both sides of this equation. Sometimes the “unfairness” of life tips in our favor, and sometimes it leaves us crushed and devastated.

Either way, how we respond to these scenarios is how we grow, how we step into our full humanity, and how we gain valuable skills like empathy and resilience.

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yin yoga and therapy

How Yin Yoga and Therapy Work Similarly

by Sara Cloostermans on category , , ,

When I started practicing yin yoga, I realized I had never come across an approach to healing that is so aligned with the approach I use when conducting therapy. The main similarity is the 3 principles of yin yoga, which is also my yield to yin approach to therapy.

Three Principles of Yin Yoga by Sarah Powers

  1. Find your edge and lean into the sensations that come up (4 or 5 out of 10 on an intensity scale – discomfort, not pain**)
  2. Resolve to remain still (in the present moment, no distractions) – practice the art of stillness while taking slow, deep, meditative breaths
  3. Hold the pose and spend time in this space (typically between 3 and 5 minutes – up to 20 minutes) to yield to the sensations, feelings, and thoughts

BOTTOM-UP APPROACH TO HEALING:

healing from the primal base of the brain (brainstem, limbic system) 
= bodily sensations + feelings

No pain (discomfort**), no gain

Jane Fonda

Three Yield to Yin Principles of the Therapeutic Process by Sara Cloostermans

  1. Find your edge and lean into the thoughts (perceptions) and feelings (subjective experiences) that come up – (4 or 5 out of 10 on an intensity scale – uncomfortable, not retraumatizing**) 
  2. Share the discomfort** with your therapist, then sit with it together (in the present moment, no distractions) while both taking slow, deep, and meditative breaths
  3. Spend time in this safe holding space (up to 20 minutes) to yield to the thoughts (perceptions become observations), feelings (subjective experiences become objective experiences), and sensations (seemingly intolerable or uncomfortable sensations become tolerable or comfortable)

TOP-DOWN APPROACH TO HEALING:

healing from the cognitive frontal lobes of the brain first 
= thoughts + emotional regulation

“No feeling, no healing”

Sara Cloostermans

**Understanding Discomfort vs. Pain

Both physical pain AND emotional trauma are stored in our bodies and minds. If not taken care of in a gentle and loving way, they add to the development of stagnation of energy, which creates energetic blockages. It is these blockages that lead to discomfort and pain. Pain can feel so intense that it seems unmanageable and intolerable.

Working through discomfort / being uncomfortable are “growing pains.” These pains help us process and integrate our experiences, so we can let be, let go, heal, move forward, and expand.

Struggling through actual pain (6 to 10 out of 10 on an intensity scale), however, is highly discouraged since it does the opposite: it leads to chronic pain / complex trauma = “issues in the tissues.”

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hard work is relative

Hard Work Is Relative, So Be Compassionate

by Sara Cloostermans on category ,

We are a judgmental bunch when it comes to ranking the hard work of others. We look at a very specific set of metrics without considering any background information and start making pronouncements: he is such a hard worker, she is so productive, he is really lazy, she is a total couch potato.

When we see a “high-achieving” person who works ten hours a day to build a business, and still fits in time for exercise, meal prep, meditation, children, etc., we call them a hard worker. And that’s fair … they are working hard.

We look at somebody who’s been home all day on the couch and say “lazy.” But here’s the truth: they might be working just as hard, maybe even harder.

  • “Person A” may be in great mental and physical health with a personality that thrives on staying busy. They may have resources to help them like a nanny or a cleaning service.
  • “Person B” could be suffering from severe depression or a physical disability that makes walking back and forth to the bathroom the hardest task in the world. The act of taking a shower may have felt impossible—and they did it anyway. 

The concept of hard work is relative. What is a person dealing with behind the scenes? What’s going on that we can’t see? What are their thoughts, their feelings? Do they have trauma triggers? Are they in physical pain?

No two humans and their sets of circumstances are ever alike, so comparing exertion and productivity is impossible. 

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finding calm

Push Pause: Finding Calm After An Emotional Storm

by Sara Cloostermans on category , ,

Think back to the last time something was really hard for you. Maybe you were stressed out or angry, overwhelmed or sad. Then think about the very next thing you had to do that day. Maybe it was something fun, maybe it wasn’t. Either way, was it easy to switch from swimming in a difficult feeling to crossing off the next item on your to-do list?

Probably not.

After something hard happens (a storm), we need to learn to push pause and find calm. That way we can more easily, and more peacefully, move on to the next activity in our day with awareness and mindfulness.

The way I suggest finding calm is by incorporating a yin activity. Think of yin and yang—the energies we hope to balance in our lives. We associate yin with being, slowing down, deactivating. Yang is associated with doing, quickening, activating. If you’re already at a place of high emotion or distress, going straight into more yang is not going to calm you down even if that activity is fun. But by choosing to focus on yin for a moment, we can find a more neutral zone. Then we can move on with the day.

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yin and the nervous system

The Power of Yin and The Nervous System

by Sara Cloostermans on category , , , ,

Just about everything you’ve done, thought, or felt today has been controlled by your body’s nervous system. Movement, emotions, stress response, healing, sleep, breath, senses, aging, digestion—all happening thanks to this central command center.

Now, think about how many of those factors play into your mental wellbeing! 

Your nervous system is responsible for the “fight or flight” response—one we are all too familiar with in today’s world. Not because many of us ever need to run from a hungry lion, but because of the hectic, high-stress lifestyle that’s become the norm. 

Your nervous system has another function that doesn’t get as much attention as it should: “rest and digest.” This is the calm down. The healing and repairing function. The self-care. Our culture often brushes this side off as unnecessary, or even weak and lazy. 

But if we want a healthy body and mind, we must pay attention to the power of yin and the nervous system.

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yin and yang

About Yin and Yang | Balancing Being and Doing

by Sara Cloostermans on category , , , ,

You’ve no doubt seen the yin/yang symbol before. Maybe in a yoga studio, on a t-shirt, or even tattooed onto the ankle of somebody you know. But do you really know what it means? Let’s dive into the deep meaning of the ancient yin and yang to see how understanding its balance can lead you to a more balanced life.

Yin/Yang: The Basics

The yin/yang symbol is a symbol rooted in Daoism/Taoism, an ancient Chinese philosophy. The yin side is the dark swirl and the yang side is the light swirl. The two swirls combined represent Qi (pronounced CHē). Qi is said to be the source of all creation and to hold all aspects of life, including our life force. 

Boiled down to its essence, yang represents the “doing” parts of life and yin represents the “being” parts of life. 

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Spark in stillness
Soul in silence
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