C (3:31)

And I think it's a very obsessive time, don't you? Yes, naturally, for everybody in terms of the amount of time that we ruminate, the sleepiness, the tiredness that we experience that exacerbates that, as well as the sort of the so much more doubt, so much uncertainty and so much more hunting than we would ordinarily do. Especially if we've stepped out of a life that we're very comfortable in into this really unknown, uncertain space. It's really understandable. So I think you're right. I wonder the same thing, you know, where, where is that line between what tips over into ocd because it is an incredibly anxiety driven, obsessive time anyway?

A (4:09)

Yeah, absolutely.

D (4:10)

And I find that it's perhaps one of the few presentations where I'm often still pulling out the old DSM because it's exactly what you just said, it's going well, sort of being given all of these instructions from all of these different people. She is following it to a T. It probably is taking X amount of hours per day to follow that to a T. You know, guidelines for how much they should be moving, for how much they should be sleeping, guidelines for the food pyramid, guidelines for screen time. And so it is this dance of this is causing you a lot of distress and dysfunction. And I guess by the criteria you do meet criteria for ocd D but then also highlighting and not in every case everyone's different. But yeah, in a lot of cases going the biopsychosocial model is a thing and there's a lot of social playing into this. And the standards, particularly for mothers, like almost down to, you know, a good mother is just joyful at every moment and never cracks the sand, just enjoys every minute. And like down to the emotional, there are expectations cast upon mothers for exactly how it should look, how we should be, how our good baby should be. And I, I think about this probably way too much where I Just think.

C (5:37)

Oh, and you know what I was thinking? I was thinking about, you know, applying the general rule of thumb, ego dystonic versus ego syntonic.

D (5:44)

Yes.

C (5:45)

But I think a lot of what is happening during this period is probably ego dystonic in that you feel like you have to follow these guidelines because you don't have the confidence. You're still. It's a developing identity and sense of self as a parent. And so you're following these guidelines because you feel like you have to. Because you feel like you're compelled to. To be a good parent, even though there's a part of. It's like, I think, reckon I could let this go. I'd like to stop. I'd like to do it my own way. I'm not sure. I mean, I don't even think that that rule necessarily makes it easier.

A (6:23)

No. To discern, because I'm going to play devil's advocate and go the other way. Based on the workshop we had last Wednesday. Tori.

C (6:30)

Yeah.

A (6:31)

Where one of the questions that came up was, what if it's ego syntonic? Because I imagine it could go the other way in this situation. It's a perfect example, and we spoke about it in the car park afterwards, was what happens when we're so desperate for certainty and a need for making sure we're being a good mom and doing the right thing and that we hang on to what we're told and we hang on to the guidelines because that's the right thing to do. And why would you do it any different? And me doing this means I'm doing it right. And no, I don't need any more sleep and know this and know that. And no, I need to do it this way because that means I'm a good mom. Do you know what I mean? Like, it's this real fusion with perfection and guidelines and rules and all of it, when really, I think it comes from a deep sense of this is going to help me stay on track. Because I'm terrified of what it might look like if there's an inch of flexibility or an inch of spontaneity, because what if I'm not a good mom or good enough? And I often wonder if that stems from underlying relational trauma or whatever else it might be going on for someone to hang on to it. And which I guess, you know, kind of adds to what Tori was saying in using that criteria of when we look at are these intrusive thoughts ego dystonic or ego syntonic? I think it's one of the spaces where it can be so blurred and we can miss it or not necessarily be able to tease it apart. I always come to. I don't know what you guys think about this, but I always look at functional impact.

C (8:12)

Yeah.

A (8:13)

How much is this impacting this person's life? Because we have. The normality of it is an obsessive time. I mean, I remember. I think I've shared this story before, but I remember in the early days, it was within six weeks. First six weeks. I think it was like the second checkup or whatever, the six week checkup. And the nurse measured my daughter's head. I was like, oh, she's got a big head. And I went. Because she got encephalitis. So I went home and I was, like, looking at her eyes and I was like, how is she looking? Because, like, if you look a certain.

D (8:43)

Way, like, you can indicate.

A (8:45)

And I was like, measuring her head. And my husband walked in while I was measuring her head, and he was like, what are you doing? And I went, nothing. And he went, what would your clients say if they saw you right now? And I was like, shut up.

D (8:58)

Isn't that the hardest thing about being a psychologist and being a parent? It's like, oh, it's almost like I know so much. And like, you get.

A (9:08)

He was like, put it down. Hand it over. Step away from the baby. I think you need to go inside and just take a break. And I'm like, yeah, okay, thanks.

D (9:18)

I think what you've both illustrated is that the ego syntonic, ego dystonic. I find it. It is so blurred because for most parents, this sense of, well, yeah, it means a lot to me to be a good parent. Like, there is this real sense of this is what I value. And then what I so often see way more commonly than not at least the clients who I work with who have ocd, often, we've got a lot of complex trauma there in their history, you know, perhaps even to the point of sort of complex ptsd, where there is, in addition to the ocd, that sort of black and white things are either like this or they're like that. And I often find that it can be very difficult for them to get a sense of, yeah, well, okay, what is good? What does it mean to be a good mother? Is a good mother someone who is, you know, nailing every meal that is homemade and made from scratch and incorporating every element of the food pyramid is that it's really trying to tangle apart, like, what are your values? And what are the values being put to you? And Trying to sort of tease that apart. And if there is complex trauma there, if there are parents who have developed over years this sense of if I'm not perfect, it means I'm a failure. Often, you know, I do a lot of EMDR in my work and often we'll sort of do that sort of work first before they're moving on to the sort of ERP and that exposure.

A (10:50)

Work with the OCD, where Big advocates if you need to address the trauma, because oftentimes OCD has manifested as a way of coping with trauma. And so if we're not addressing the trauma, we're just going to go around in circles with OCD while we've. That's what we've noticed anyway. And I think a lot of the literature says the same. And you're right, like it's this idea of how intense is it, what other impacts is it having on this person? Can they step away or are they. Then I guess, using the example I used with myself, like I could have gone away, sat on the couch and just sneakily spent five hours on my phone Googling encephalitis symptoms instead of sitting down and just having a cup of tea and taking a break.

C (11:36)

And were you able to move on?

A (11:37)

Are you able to move on?

D (11:38)

Yeah.

C (11:39)

Or were you preoccupied with the urge to go back and measure again?

D (11:44)

Yeah.

A (11:44)

Or book over and over appointment and get it tested and do this and do that, or go back to the nurse or call nurse, call at 3 o' clock in the morning because you can't sleep or.

D (11:53)

Yeah. And I think this is where that early detection is so important because I can't remember if I mentioned this to you, Celine, when we caught up, but it would have been ages ago now. But I remember, like in uni, OCD was not. I don't think we, I mean, maybe we did and I missed the lecture, but I. I'm 99% sure that we didn't spend time on OCD.

A (12:16)

It was a part of a lecture for us in psychopathology. But the example that the lecturer gave, and it was so intriguing to me, but also I felt so sad in that moment. Like, he often talked about how people with OCD with contamination and again, it was just the textbook stuff. It was not all the other things that we see of would wash their hands so often that they, you know, the skin on their hands will deteriorate and they'll crack and bleed and all that kind of stuff. So I really resonated with that story of like, how distressed must this person Feel and be to kind of get to that point.

D (12:51)

But that was it, at least I found. Almost by chance, I ended up working with a lot of OCD after a colleague was like, oh, there's this woman, Celine. She's got this book, like, because I was talking about a client and she's like, this client have ocd? And I was like, oh, I don't know. And so I got this book, read through his stuff, did some more supervision in the area, and it just made me think, oh my gosh, how many people are missed because it's so under recognized. And.

A (13:22)

And like you said, a lot of it is brushed off as normal maternal. But also a lot of what we talk about has happened with dads as well. Like, you know, a lot of maternal and paternal anxiety, sense of responsibility. Only, you know, today we started talking about providing support for dads more and more and all that sort of stuff too. And Panda do a lot of wonderful work with that. They've started doing a lot of stuff for dads as well. But yeah, it's just this thing of a lot of it gets brushed off as being a new parent. Or like you guys talked about earlier, a lot of it naturally is an obsessive time and a heavy preoccupation wearing, like a lot of the time fight and flight because we're so sleep deprived. And also, when you're postpartum, the hormone come down is so intense. Like, I remember going through it and I said to my husband one day going, oh, my God, if you were in my head right now, you would probably call the police. And he was like, why? What's going on in there? I'm like, these anxieties, like, they're just so intense. And I'm coming at it with awareness. If I had zero awareness because of my education and one work, I would be scared, terrified, and I'd probably take myself to the public hospital.

D (14:40)

Like, it's such a good point. There's this sense when you're a psychologist of you've got that almost metacognition of. Oh, yeah. Like it's almost natural cognitive diffusion in a way. Oh, yeah, there's that. Yeah. All right, we're on day three, postpartum. Yeah, there that is. Okay. But you're right, if you didn't know, you'd think, what is going on up there? What's happening in here? Yeah, yeah.

C (15:04)

And the trouble is, for so many people with OCD be is that rather than asking for help, they hide away in shame.

A (15:10)

Yeah.

C (15:10)

I mean, you yourself, Celine said you Know, like, my God, if my husband knew what was going on in my head.

A (15:16)

Yeah, yeah, yeah, yeah, yeah, exactly. Right, exactly. Yeah.

C (15:21)

And so. So it doesn't, you know, lend itself to people letting their loved ones know no, they need assistance.

A (15:29)

Yeah.

D (15:29)

I find it's a really fine line in the perinatal space of validating and normalizing and not dismissing.

A (15:40)

Yes.

D (15:40)

And I can't remember her name off the top of my head. I should have looked up. Is it Karen Kleiman? She's got that book, Good Mums have Scary Thoughts. I don't know if either of you have heard of that. She works a lot in sort of postnatal anxiety. I'll see if I can look it up and send it to you after. Yeah, yeah, yeah. And it's this beautiful picture book, all these gorgeous illustrations. And it's about. She talks about how, like, the overwhelming majority of new parents do experience intrusive thoughts. And she really does a beautiful job of sort of, like, I often gift it to people now, to friends having babies of sort of. So that they can go, oh, okay, I guess this is a thing. And I think resources like that are really beautiful, especially because she's got a little bit in there of like, okay, when does it get to that point where you go, oh, this actually could.

A (16:24)

There's more to this. Yeah.

D (16:26)

But, yeah, I think so much. We. Lovingly, again. So lovingly, lovingly. With new parents, it's like, oh, of course, of course you're feeling overwhelmed, or, of course you feel anxious or, you know, of course you're feeling really down, you've had no sleep, and, you know, say things like, yeah, that's really normal. That's really common. And then there's the risk of. For the parents, where it is beyond that realm of acceptable, beyond the realm of fine, there can be this risk of them feeling like, oh, well, maybe this is just. This is it, I guess. And maybe I just wait for it to pass and then.

A (16:59)

Yeah, yeah, yeah.

D (17:02)

Hey, Tori.

B (17:03)

Hi, Celine.

A (17:04)

Did you know that we run our own courses here at Melbourne Wellbeing Group?

C (17:08)

I did know that. In fact, it's one of my favourite things we do here because it's a great way to help psychologists and other clinicians learn more about ocd, which means.

A (17:18)

We get to help more people. So if you're a clinician who works in mental health and you're interested in learning from us, then get in touch.

C (17:26)

For more information, head to www.melbournewellbeinggroup.com and click on the webinars and Books tab.

A (17:34)

Alrighty, back to the show.

C (17:40)

What do you think clinicians need to know? What would you recommend to a clinician who maybe doesn't have as much experience in the perinatal space, but has a referral, is working with someone who is a recent parent or perhaps has a client who's pregnant? I mean, what would your recommendations be to them in response to the things that we're talking about now about managing the line between validation and dismissiveness?

D (18:09)

Yes. You know what? I wish I had a really good answer for this because I find that even within myself as a psychologist, I'm still trying to navigate that, as in the line between saying to someone, it is so understandable you're feeling this way. When you look at the environment that you're parenting in and the life experiences that you're bringing into it, of course you're going to be feeling this way and everything is going to feel so intense and it's all going to feel make or break. And this is really not okay. You know, this is actually potentially a sign of mental illness that we have to explore. And so, I mean, maybe that's the answer. Maybe it's sort of try to do.

A (18:51)

Both, you know, case by case is what I'm hearing.

D (18:55)

Yeah.

A (18:56)

Look at the context, look at the environment. Take into the consideration their personal factors. What are they bringing into it?

D (19:02)

Yes.

A (19:02)

How is it impacting on them?

D (19:04)

And I often use this phrase normal but not fine, where parents will often be like, is this normal? Is it normal? And as we're exploring that, as we're going, you know, is this in the realm of sort of a diagnosis or not? Not that it would really change what we do about it anyway, to be honest. But going, you know, even if this is quote unquote normal or common, that doesn't mean it's fine. You know, birth trauma is statistically normal and common and pregnancy loss is statistically normal and common. Normal isn't fine. And so I think if clinicians can hold that in mind of, like, I want to validate, but I also don't want this person to leave the room thinking, oh, I guess I just sort of almost need to just suck this up, then maybe this is just what everyone goes through. I think screening, like, just something like the Y box, if you get a whiff of anxiety, even just kind of saying, look at my. Because I find a lot of parents, particularly even the term ocd, they're like, what? Because they think about the person washing their hands or whatever. Sometimes it is that. Yeah, but just Going, look, this is something that I just screen. It's something that can be really easily missed. So I just like to call it overkill, but it's just something that I like to do anyway. And, yeah, trying to provide both, perhaps that validation, but not dismissing that this is really significant.

A (20:30)

Yeah.

C (20:30)

Well, first of all, that's an excellent answer.

D (20:33)

Yes, thanks. But I think the phrase that came.

C (20:37)

To mind while I was listening to you now was, you know, be alert but not alarmed and also not feeling like. I remember the pressure, particularly in the early years of feeling like I had to have the answer straight away. But we don't. We don't have to have the answer straight away. We can be curious, we can explain, express wondering with our clients. We can wait and see. I mean, obviously we're not talking. We're talking outside of risk here. I mean, obviously, you know, if there are imminent risks, but that's a different conversation. But if we're talking about someone, why not just say, let's explore these ideas. Let's see what happens when. We've talked values today, we've talked about how you want to be parenting things you want to let go of. Let's experiment this week with letting some of those things go, and let's have a look at where we're at next week and how much is persisting and how much you've been able to shift. Let's just experiment with a few things and see. I mean, we don't have to know in a single session whether it does or doesn't meet the diagnostic criteria for OCD and whether someone needs a referral to a psychiatrist and whether they need to embark on ERP straight away. We often have more time than it perhaps feels and we can be extremely helpful to our clients even without knowing for sure if it is OCD or not.

D (21:53)

Yes, absolutely. I think as you were seeking, I was just thinking about countertransference around. Often we can, if we're meeting someone who you can see, they're like, really OCD or no ocd, they're really in the trenches. They're really like, oh, my God, what is going on? Like, what is this? And I think we often. And it's certainly something I'm really conscious of. I've got that many sort of like, grounding tools in my home office of really conscious of, like, noticing that urgency in the therapy space of quick, figure out what this is and just sort of like, just exist now. Because so understandably, like parents are. It's such a shell shock when you're Not a psychologist especially to like, oh my gosh, can I just sort of like go back to what things perhaps were like at a point in time? And so I think, yeah, you paid a really good point that asked the aspect. Just actually staying grounded and staying curious and not almost being drawn into like. Right, let's jump into the Hierarchy and Session 2 and let's sort of. Because then often we're missing all the attachment, developmental juiciness and richness that needs to be explored anyway.

A (23:07)

Exactly. This has been such a wholesome chat. I'm sure we could probably go all night. Yeah, we could. You think this will be a nice spot? Wrap up. Tori, do you want to do the concluding questions?

C (23:21)

Bianca, some questions that we ask all of our guests. The very first one is in the interest of normalizing intrusive thoughts, wondering if you have any particular intrusive thoughts that you experience that you wouldn't mind sharing.

D (23:34)

Oh, yes, definitely. So particularly with my first son, the intrusive thoughts are definitely related to, oh my gosh, am I going to walk into his room and he's not going to be breathing. And in some ways I still, I maintain that it was healthy. I made a very conscious choice to not buy a baby monitor the way that we were in apartment at that point. And I knew, particularly with. I don't know if you've seen how technologically advanced baby monitors are now, where they hook up to your phone and whatever. He was close enough so that if he made a squeak, I could still, I'd still hear him. The doors were open. But I definitely noticed in those early months, and again, it helped that I had some awareness of it, but definitely thoughts around, yeah, what if things fell into the cot? What if I take him for a walk and the pram gets knocked over around his breathing? I probably had in some ways an extra layer. I had two pregnancy losses prior to having him. And so I was. Those thoughts were really rampant during pregnancy and also in that fresh postpartum stage as well. I feel somewhat relieved that they didn't take over and get anything sort of too rampant. But certainly, and probably even now, I have little niggles of things pop up of again. I think being a psychologist adds a layer of, you know, my son did something super sweet for me the other day and he was like, mommy, I went to the garden and I picked you a yellow flower because yellow's your favorite color. And yeah, I was like, oh, that's so sweet. And then it was this sort of like, is this him? People pleasing. Is this him?

A (25:14)

Trying to take responsibility for my.

D (25:18)

Pick him up from Kinder. His kinder teacher said the other day, he talks about you all the time. He wants to make you things. And again, I was like, oh. And then I was like, oh, is that. I almost wanted to ask her. I didn't. I wanted to be like, did the other kids do that? Like, is that. So it comes up. I find it's mostly related to actually being a psychologist. And I see we know too much here. So many things every day with all that stuff like that. It's almost like some voice with every single case note I've ever made, like honing in on something. But I feel like I've gotten pretty good at going, oh, yeah, there's.

C (25:54)

I can really relate to that one. I feel like I've got a really close relationship with my girls. And then I get these intrusive thoughts about enmeshment.

D (26:02)

Yes. Yeah, that's a great one. Is he individuating enough? So, yeah, yeah.

C (26:14)

And insight, you know, and whether I would have any insight into actually the pathology of my own family.

D (26:21)

Yes. And then as my husband always likes to say is like, would an insightless parent be really wondering about whether they were insightful enough? I'm like, he's like a psychologist by proxy.

A (26:36)

That's great.

C (26:37)

And the other question we always ask our guests is to share with us something that you know now that you wish you knew earlier.

D (26:45)

I mean, relevant to this theme of the perinatal space. I wish I was more aware of the very subtle environmental messaging about what it means to be a good parent. There are some amazing resources. I would recommend Dr. Sophie Brock, her podcast the Good Enough Mother, and also the book Matrescence by Lucy Jones. Yeah, there's just so many subtle and infuriating ways where we're conditioned and then we find ourselves going through the motions trying to nail all of these standards that are ego dystonic, that really where you really go, hang on, do I really value this or do I just feel like I should? So it would be that. It would be almost like, again, the social of the biopsychosocial, of just I wish I'd known or being more alert and I wish I'd been more angry. I think anger is definitely, like, has risen much more in parenthood, but in a really good way, where rather than seeing one of those subtle things and being like, oh, gosh, am I doing that? Oh, my goodness. So, yeah, probably that. I wish I knew that more would have made a big difference.

A (27:58)

All of these amazing resources we will add to the links show in the episode summary so you can head over there and have a look at them. One of the other resources that I love, speaking of resources is called the Magic Years. I can't remember who the author is, but she talks about the toddler years in particular. And it's. The whole book is just a beautiful reframe in terms of understanding. It's a beautiful reframe in terms of helping understand why your child is doing what they're doing. You know, it's the age old when they throw food off their table, they're testing gravity or they're just trying to figure out what texture feels like. They're not being defined.

D (28:43)

It's trying to ruin your day or.

A (28:44)

Ruin the day or be messy or whatever. I remember my supervisor, you're a terrible cook.

C (28:49)

And I demand, and I don't like your food. I demand better service.

D (28:54)

Well, look, my oldness was four. I do get that sometimes.

A (28:59)

Yeah.

C (29:02)

But you are so much more innocent than it actually. Perhaps we interpret things today.

D (29:07)

Yeah. We can so easily personalize it, I think.

A (29:10)

Not just that, but like we might have been parented that way.

D (29:13)

Yeah.

A (29:14)

And so we're bringing up, when we talk about reparenting, like we're bringing up the messages we heard or we're feeling the messages we heard as a kid in those moments and are projecting it onto our children. I remember my supervisor telling me a really lovely story of when. I mean, his daughter is in her 20s now, but when she was younger, there was a moment where he was like, just go to sleep. But she was just like so busy moving around her cot because she had just learned how to walk. And so what this book talks about is when kids are winding down in particular, you'll often see them really kind of, you know, when pets do the Zoomies, it's kind of their version of the Zoomies when they're trying to wind down, but they're also their brains processing the developmental milestone that they're at. And so for her, it was walking right now for my daughter, her vocab has exploded. So bedtime is just pouch or Joey or whatever. Some other things she's picked up from a book or all these other stuff. And I always now hold this in mind of going, she's just practicing. She's just. This is her wind down. Give it some time, give it some space. Which is very different to frustration, anger, irritation, feeling like you're failing because it's, you know, half an hour or an hour and they're still not asleep or whatever else it is. But anyway, this book kind of reframes things in that way in terms of kind of providing a really lovely explanation into why things are happening the way they are so we don't get caught up in the projection of the judgment that can happen and can come up.

D (30:52)

That's so relevant because you're absolutely right in terms of when our little ones are having their big emotions, often there is a voice in our heads of a relative or, you know, when we think about, you know, 20, 30, 40 years ago, parents weren't struck like that was just bad super nanny, just bad behavior. But yes, yes, even recently my daughter had lovely expression on the floor out in public and an elderly woman audibly tsked me like, yes. And it is hard to not feel like even for a split second I'm like, oh my God, she's being so naughty. And in my head I'm like, I never call her naughty. She's bloody too. But I think that's a. I'm gonna read that. I'm gonna look that up. Sounds like a good recommendation.

A (31:35)

It's a really good one.

D (31:36)

Filter out all the external noise.

A (31:39)

Yes, totally. Oh, this has been so wholesome. Thank you so much, Bianca, for joining us.

D (31:45)

Thanks so much.

A (31:46)

It's been an absolute pleasure.

D (31:48)

Aww. No, thanks so much for having me.

A (31:53)

You've been listening to Breaking the Rules, a show for mental health professionals designed to help you build confidence in treating obsessive compulsive disorder.

B (32:01)

This podcast is brought to you by Melbourne Wellbeing Group, a psychology practice based in Melbourne with a special focus on treating OCD. To find out more, head to our website, MelbourneWellBeingGroup.com all one word. That's MelbourneWellBeingGroup.com this podcast was made with.

A (32:19)

Strategy and production support from Wavelength Creative. To make sure you don't miss an episode of Breaking the Rules, be sure to subscribe to or follow the show in your podcast app. And while you're there, leave us a five star review. It really helps others find the show. I'm Celine Galgay.

B (32:37)

And I'm Tori Miller.

A (32:38)

And we'll be back next episode with more reasons to convince you to get messy, have fun and break the rules.