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A
This is Breaking the Rules, a show for mental health professionals designed to help you build confidence in treating obsessive compulsive disorder. I'm Dr. Celine Galgetz and I'm a clinical psychologist who works extensively with OCD.
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And I'm Dr. Victoria Miller, but you can call me Tori. And I'm a clinical psychologist who works with young people, including those with ocd. Through our shared professional experience, we've found that effective treatment of OCD requires commitment, creativity and the recognition that things can sometimes get a little messy.
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They sure can. We want to empower clinicians to be able to work with their patients in new ways to treat OCD with confidence. What is it like to be parenting a child while you are experiencing symptoms of ocd? If you're curious to know more, listen in as we speak with the lovely Dr. Bianca Mastromano, who is a clinical psychologist with training in clinical and forensic psychology as well as early parenting and perinatal and infant mental health. Early in her career, Bianca recognised that supporting young families is key to mental health prevention. This insight shapes her trauma informed evidence based approach where she focuses on both parent and child's mental health.
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In this episode, you'll hear us talk to Bianca about her work as a perinatal clinical psychologist. In particular, how she helps parents to navigate the emotional challenges of preconception, pregnancy and early parenthood, especially when there are significant mental health challenges. Bianca reflects on what she's learned from the parents that she works with and we all reflect on the insights that we have gained from being parents ourselves. Let's get started.
C
Hi, everyone.
A
Welcome to another episode of Breaking the Rules. Today we are joined by the lovely Dr. Bianca Mastromano who is a clinical psychologist working in the perinatal space. We are so excited to chat with you today, Bianca. Thank you for joining us.
C
Thanks so much for having me. I'm delighted to be here.
A
And hello to Tori.
C
Hello.
A
Hello.
C
Good to see you. We have solved our tech issues.
A
She's back.
C
All the kids are in their cots. It's amazing.
A
Yes, they're all asleep. Okay, Bianca, tell us a little bit about yourself. What got you into psychology? Into the perinatal space?
C
Yeah, good question. How long have you got? We'll try to. I'll try to. I definitely didn't plan to end up in the perinatal space. I planned to study law and then at the last minute I discovered forensic psychology and I was doing VCE psychology and I thought this looks like a really nice combination where you can do these sort of Law subjects and psychology subjects, once I sort of clocked onto that as a career option, jumped really hard, you know, into my undergrad in forensic psychology and then my honors in forensic psychology. And as I was moving through, particularly my honours year, which is really do one big research study, quite quickly became really interested in when people are at the stage of being involved in the justice system, you know, often where you know, there's behaviors that are really dysregulated. It's almost like mental health meets the law. Things are at the real pointy end. And I sort of became a little saddened in a way by rates of things like rates of reaffir offending and the chances of turning things around once someone is already so far down that road. And so I ended up, I read through probably hundreds of supervisor profiles when I was applying for postgrad because I really wanted to work, I guess in forensic prevention. And it sort of led me to an incredible supervisor at the University of Melbourne, Dr. Sophie Havocurst. And all of her work was in a program called Tuning into Kids. And that was a program really designed to catch children who have perhaps been identified by a teacher or by a parent as presenting with quite challenging behaviors. And it's an emotion focused parenting program really designed to help parents reflect on their own experiences of being parented, but also to build their knowledge around sort of what it is that our little ones need to I guess, reduce those instances of emotions becoming really out of control. So I did four years working on that on a pilot trial of a new way of delivering that program. And so sort of as I was doing that it became clear that I was working with parents of sort of primary school age children. And I just thought, oh gosh, imagine if parents had this information in a way or were able to go through this process even earlier. So I sort of just kept going backwards. So between having my own children, I did training in perinatal and infant mental health. And yeah, now I very much work with parents or parents to be whether it's their navigating pregnancy or losses. But you're probably. Yeah, about half the work is sort of new parents of toddlers, young children and working with them not only to process their own stuff that comes up as it does when you have kids, but then to also to support them on what on earth do I do when I've got a toddler who's like lying face down in the supermarket telling me they hate me? Yeah. So I sort of ended up here accidentally is the long answer to that.
B
Question and how Are you finding the experience now that you're here?
C
I love it. I absolutely love it because I find that particularly when there are babies and toddlers involved, their brains are so plastic. So you see change at that end sort of quite quickly. I find it really rewarding to work with parents who perhaps didn't even realize they had all this stuff there until they had kids. I think the most common scenario I see is parents who, like, I did heaps of therapy. I like sorted my stuff out before I had kids. So like, we're good to go. And then this baby comes and it's like this, I often say it's like this little trap door appears and it's like there's all this other stuff there. So I actually love this work. I love helping parents in a way to provide that reparenting to themselves through therapy. And I also love, in a way, even though babies and toddlers aren't the client, I'm certainly holding them in mind when I'm working with parents who are often bringing their little ones to session too. I just find it feels really like impactful work. I really, really can't imagine doing anything else. And so how long have you been.
B
Doing the perinatal work for?
C
Perinatal work now? Probably four or so. I'm trying to think when I started seeing clients, I started seeing clients back in sort of 2017 and since then it sort of just became less and less forensic Y and more and more early parenting. So, yeah, I guess it's about four years sort of out of udc, seeing parents.
A
Yeah, it's such an interesting space to be in and there's certainly a lot of parents and parents to be that we see come through our clinic who are so concerned around what's the impact that my anxiety or OCD is going to have on my children. Am I going to be okay? Like, there's such a huge preoccupation with the responsibility of becoming a parent. And you know, I often say to my clients, the fact that you're even thinking about this tells me you're going to be okay because you're aware, sometimes too aware. But you know, it helps with the ability for self reflection and to ask questions and to gain knowledge, but also to keep doing the work. Because like you said, you think you have dealt with stuff and then buttons get pushed and you're like, I thought.
C
I had dealt with this or it.
A
Shows up in a different way or something else happens. And so tell us a little bit about that in terms of what are some of the Things that you notice with that preoccupation. And I remember when we met up for coffee, we had this conversation around what are some things we can talk about? And you've been doing a little bit more reflecting since then. You mentioned before we started recording. So please share that with us and enlighten us a little bit around what that looks like.
C
Yeah, sure. Well, I think I feel that almost the need to jump in on what you just said is exactly right. The fact that parents are reflecting on this is such a positive sign because one of the biggest parts of my doctoral thesis was on this concept called parental reflective functioning, which is referring to a parent's ability to hold in mind what's going on for me. Am I anxious? What are the thoughts coming up for me and what might this be like for them? What's going on for them? And as you said, while we don't want to sort of be hyper mentalizing, like hyper focused on. On both of those things, there's so much research out there now around parental reflective functioning. It's so protective if parents are simply seeing their children, holding them in mind, that doing a brilliant job. And I guess in terms of what I see is probably similar to what each of you see. We know that there is a really strong link between adverse childhood experiences and the development of mental health challenges. And so naturally, what we often see when we're working with clients are far more common than not. Clients who have come through, obviously varying the range varies in terms of how significant those developmental challenges have been. But clients who are coming in with their own developmental wounds, their own attachment wounds, and so very often these are clients, particularly before having kids, who may have found other ways to cope with those wounds. If, if not through therapy, it might be they keep really busy or they tick lots of boxes and they achieve a lot and they find ways to feel, quote, unquote, in control. And then they have children. And it's really hard to actually sustain that with a child who very cleverly brings in their own ambition and their own preferences. And so very often I'm working with parents who are so acutely aware of this is what my experience was as an infant, as a toddler, as a child, this is so not what I want to impart onto my own children. And often a struggle with. Where is that line? I think that comes up a lot of if my little one is upset, upset, if I set a boundary for some parents, particularly parents who've experienced a lot of trauma, they watch their child become upset and there is that intrusive thought of, is this their trauma? Am I harming them? We hear so much, particularly when we do our perinatal training, so much around the normality of intrusive thoughts, particularly there's a lot of focus on those harm related intrusive thoughts. You know, what if a truck comes and knocks the pram over or what if a painting falls onto the crib or all these sorts of things. But I think parents are often caught off guard by the fears that they notice around emotionally damaging their children. It's probably not helped by the fact that there's like thousands of very black and white Instagram accounts and products that almost go like, if you do these five things, this is how you will ruin your child.
A
You must hold your calm all the time.
C
Yes. Yeah.
A
You need to be the calm in your child's chaos.
C
Absolutely true.
A
But I mean you're human also. Yeah.
C
I found that even like when I was freshly postpartum especially even I would get like I was getting sucked into things and, and I really had to be like, no, no, no. That is like from an evidence based perspective that is fundamentally untrue. Yeah.
A
But there, it's like the emotions are so strong.
C
Yeah.
B
And you're just looking for certainty. Right. There's so much doubt and there's so much worry and you alone with all of your thoughts and you just want to find a sense of certainty and reassurance that what you're doing is okay and isn't going to harm your child. And yet, I mean, we can be pretty sure, but we also can't know for sure. I mean, I make the joke all the time, you know, with my mum, friends, like, oh, that'll be what they talk to their psychologist about when they're.
A
Oh man.
B
But I'm not really joking, you know.
A
Yeah. Journal you bought.
B
I'm just putting it out there so that like, like, you know, it doesn't look like I get caught off guard. Later.
A
When I was about to go on mat leave the team, beautifully bought me like a whole bunch of stuff. And one of them was a journal that was blank to fill the pages that Tori was like, this is for you to fill all the like milestones and memories. And I was like, nah, this is what she's going to take to therapy one day with all like my mum this and my mum that.
C
I think in some ways I think that's a really like healthy, reasonable way to think. Right. Because particularly like if we think about examples where there's been really significant childhood trauma, we hear this Term sort of cycle breakers. I don't know if either of you and I even, like, I definitely have a reaction or, you know, to that term because it's so like, you're either breaking it or, you know, like perpetuating it. Yeah. And so I often use terms cycle shifting. We're just sort of shifting things because really, like, in most families, our children are going to have things. They're not going to turn out as these sort of pristine robotic creatures. But I think often parents feel like they should, or it's their job to almost set up everything, just like so. So. And it comes from such a place of love, which is why it's so hard to find that line. Even this sense of, I see it a lot in parenting work of, oh, well, I could set a boundary, but they get upset. I don't want to be the cause of their upset. And it's a lot to sort of pull apart. Hey, Tori.
B
Hi, Celine.
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Did you know that we run our own courses here at Melbourne Wellbeing Group?
B
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
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.
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For more information, head to www.melbournewellbeinggroup.com and click on the webinars and Books tab.
A
Alrighty, back to the show. I feel like the undertone of all of that is emotions are not. I'm going to use good and bad just for simplicity. But, like, bad emotions are not to be felt. Sadness, anger, frustration, irritability, boredom. Like, we need to protect our kids from that. They have to be happy all the time. But our job isn't that right? Our job is to help our kids feel their feelings, not to protect them from their feelings. It's to allow them to learn how to feel those feelings because they're going to have them. And when we're setting the boundary, it's okay to set the boundary, but also say, I can see you're upset by that. I know you're frustrated. Do you need a cuddle? Do you need some time? Do you need some space? What do you need from that? But we're not going to watch Peppa Pig at 2 o' clock in the morning. Yes. Or whatever else it might be for whatever age it is that you're dealing with. And I think all of these Subtle messages that we see in here. I feel like they do have this undertone of we have to protect them from. These emotions are not good. You need to. But that's not really what a lot of them are saying either. But because they're so black and white, it kind of lends us to start thinking good emotions versus bad emotions or helpful versus unhelpful. But we need to be able to feel all of them. There's room for everything.
C
It is. I don't know if you find this working with parents, but particularly if I'm working with clients who have ocd. In some ways it gets very meta, doing ERP and exposure for themselves, within themselves, to feel like, okay, I can have this feeling, it will peak and it can fade. But then it's almost like through doing that work, they're facilitating that for their child or their toddler, who perhaps they've been in a pattern of rushing in or avoiding things or whatever it is. And so in some ways, for their little one, there is an exposure process to go through as well, which is super important. I can have this feeling. I can be worried about saying goodbye at drop off or that first swimming lesson or whatever it is. And then that feeling goes. And then I do this really cool thing and I have a great time. And, yeah, I did it. Yeah.
B
I mean, let's talk about parents with ocd, because while we were sort of giggling before, I was thinking about the. I suppose I was reflecting on my own experience that I could sit with that discomfort because I don't have ocd. So therefore my discomfort doesn't become distress, doesn't become disabling forms of panic. And so I can crack a joke and laugh about it because, you know, I'm not feeling shredded. Shredded by the emotions. And I guess I know that's one of the things we were thinking about talking about today was the experience of managing this experience of parenthood as someone with ocd. I'd love to hear your thoughts, Bianca, about just, you know, the clients that you've worked with, what you've experienced.
C
Yeah.
B
What you've seen.
C
Yeah, I think it's absolutely. You're right. There is this, I mean, hugely added layer for parents with OCD because they notice these intrusive thoughts and they're not psychologists who have, you know, studied them and are like, yeah, intrusive. Like, for them, as we know, there are the worry beliefs. There's this sense of, I'm having this thought. Is this in some way grounded in reality? Does this make me a bad parent. And so there is this really difficult as you know, the sort of the loop and the cycle that plays out for these parents. And often what I find in a parenting context is accompanying that is really significant burnout. And even from a sleep perspective, like physical deprivation, which in some ways can then reinforce that loop, I think something I see really commonly and it's, I even feel nervous talking about it on here. We could edit it out later. But something I notice working the perinatal space is even the topic of sleep is so polarized. I don't know if either of you have noticed that. It's kind of like there seems to be these two really extreme ends of like you co sleep, you wake up 100 times a night and you know that's nature's way. And at the other end it's like, you know, you leave your baby to scream for hours. Like there's these and anywhere in the middle sort of gets lost or sort of gets pulled to one end. And so I think what I often see for parents living with OCD is they're self sacrificing a lot in terms of things like, you know, if their little one, you know, squeaks and mom or dad feel like I can't get to them, I can't soothe them in time. And so they'll do things like not attend to personal hygiene or they might be like, oh, I've gone like four days without a shower because if I get in the shower for one minute or two minutes and they're upset and they're self sacrificing. But even around sleep they'll find it really hard to make these changes. Whether it's like, okay, maybe I'm rocking them to sleep in the rocking chair and maybe I want to transition to like, I'll lie next to their cot, but baby gets upset if they're lying in the cot and so they'll just go, oh no, no, it's fine, I'll just keep getting up every hour and just rock and rock and rock. That fear of baby being allowed to again ride that wave of like, this is a new hard experience, but mum or dad's right here with me and I know I can sort of be okay. And so I see a lot of burnout. I mean, I'm sure it happens and I know it happens with OCD and people who aren't parents, but it's so much self sacrifice trying to nail every heard of standard. You know, whether it's they hear something in an article about this can be good to do with Children and then parents feel like, right, well, I need to do that to a tee. And so often there's this sense of like losing touch with who am I? What do I like spending every sort of second day and night of. I just need to make sure that my little one isn't upset again. It comes from like the biggest ever place of love. But I think burnout, sleep deprivation are huge things I see perinatally with ocd and it breaks my heart to think of, you know, often delay to diagnosis and so much getting, especially getting written off in the perinatal stage of like, oh, anxious new mum. I don't know how parents who aren't in treatment and getting that support are actually getting through. I don't know if you, either of you feel the same.
A
Oh, yeah, 100%. Yeah, absolutely.
B
I mean, the dysfunction that can occur can be so significant at this time because you're like, the stakes are so high. Like the sense of responsibility has quadrupled. Like, okay, sure, like, I didn't want to put myself at risk or my loved ones, but now the baby, you know, stories, people just losing time researching, trying to find that certainty around what choice they should make, losing touch with what their value system is for themselves and disconnecting from their own sense of self, just paralyzing the searching.
C
Is such a good point. It's awful because on one hand you don't want to sort of demonize seeking, you know, looking up resources or gathering information. But then, yeah, often parents with OCD might spend hours and hours and hours each day looking up everything. And then there's often a grief of feeling like they're missing, you know, their baby hits 3 months, 6 months, 1 year in this sense of, of, oh, I feel like I haven't, you know, in some ways it's been a long year, but then in some ways I feel like I've missed so much. And so there's a lot of grief, I think, involved in this space as well.
B
Well, it's the great paradox, I reckon, of ocd, you know, that in an attempt to protect the child, you know, sometimes you can end up not being tuned in or actually experiencing time with the child because you're so worried or frantically researching or. Or engaging in compulsions to protect the child. And it's just torturous.
A
It is. And the spontaneity is gone. There's no present moment, awareness. There's no playfulness. Playfulness, yeah, which is so important. Flexibility, which is so important in each of those moments. And Charlie, agree with you Guys, it's one of those things where I remember saying to a lot of clients with OCD who are parents saying, you know, you're really worried about this, but it's already here. What you've worried about has already occurred, because even though you're not being present and you know, you're worried you're not being present, but you thinking about that is actually taking away from the presence, so you're not actually present. And it is. It's very much part of that paradox in terms of what you've fear is going to happen, actually happens. And we. That's why we call OCD a false security blanket, because it's not. It makes you think that and feel that you're achieving safety or responsibility or whatever it is. But like Bianca said, through nothing but love and good intention, we're actually missing out on all those other things that are equally important. But I hope that parents listening to this, this thing going, I need to be more playful. I need to be more spontaneous.
C
Well, this is the thing, right. I find it's such a. And I definitely haven't perfected it. It's such an art, right, to almost feed this back. And I find this even, like, even when I was doing just that four years of just doing. Tuning into kids with. With my doctorate is so often. And these were parents without OCD who were presenting with children these big emotions and big behaviors. And often they would come with, like, all the books that they'd read and like, the list of strategies and this sense of nothing works, nothing works. And through going through that tuning into Kids program, where we're just wondering what's going on for them. We're not doing. We're just sort of, what's this about? And what comes up for you? What's that like for you? You see them get really angry. What do you notice within yourself? I think traditionally there has been such a focus on, you know, there's one way to do this, or, you know, I just need to find the right strategy. And it's often reinforced, I think even now, perhaps in some areas of sort of, this is what a good child sort of looks like. This is what a good baby looks like. And so parents are made to feel like if I can just sort of get the formula right, it will work. And then if we think about, well, what does it mean for something to work is that a child who's just sort of like even just calm all.
A
The time, like, emotion all the time.
C
Yeah, I. That's like. I think one of the biggest phrases that I hear is like, oh, I've tried everything and nothing works.
A
Yeah, we hear that too. Yeah.
C
What does it mean?
A
What does that mean?
C
Work. Yeah. How do we know if it's worked? How do we know what it doesn't work? And yeah, what's our aim?
A
Like, what does that look like?
C
Yeah. So I think this stuff is hard enough as it is for parents often who aren't living with ocd, and then OCD is laid on top. And I found a lot as well is often that OCD diagnosis hasn't come until perhaps they've hit that perinatal life stage and things have become really hard and perhaps psychiatry has been involved. And so they've already had this humming in the background for maybe 20 or 30 years.
B
Thanks for joining us for part one of our chat. Join us next episode as we conclude the conversation.
A
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
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 Website Melbourne wellbeinggroup.com All one word, that's Melbourne wellbeinggroup.com this podcast was made.
A
With 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 Galga Sketch.
B
And I'm Tori Miller.
A
And we'll be back next episode with more reasons to convince you to get messy, have fun and break the Rules.
Episode: Why revisiting a parent’s own childhood can help them as a new parent
Hosts: Dr. Celin Gelgec & Dr. Victoria Miller
Guest: Dr. Bianca Mastromano
Date: April 28, 2025
In this episode, Dr. Celin Gelgec and Dr. Victoria (“Tori”) Miller sit down with clinical psychologist Dr. Bianca Mastromano to explore why revisiting a parent’s own childhood and emotional history can play a crucial role in supporting new parents—especially those navigating OCD and other mental health concerns during the perinatal period. Drawing on clinical experience and personal reflections as parents, the conversation spotlights trauma-informed, preventative approaches, the challenges of breaking intergenerational cycles, and practical insights for clinicians supporting families.
This episode provides clinicians with an in-depth look at the interplay between parents’ own childhood experiences, the challenges of perfectionism, and the distinctive obstacles faced by new parents—particularly those with OCD. Realistic, compassionate reflection is encouraged, as is a shift away from black-and-white, all-or-nothing thinking about breaking cycles or achieving perfect parenting.
The discussion is rich with clinical insights and normalizes the emotional messiness of parenting, while affirming the value of curiosity, flexibility, and self-compassion in both clinicians and parents.