Kara K - Surrendering to the Storm

What happens when a perinatal mental health specialist finds herself overwhelmed by postpartum OCD, PTSD, and anxiety—right in the middle of a pandemic? In this powerful episode, I sit down with Kara Kushnir, LCSW, a therapist, author, and mom who shares her deeply personal journey through birth trauma and postpartum mental health struggles.

Kara opens up about her C-section experience gone wrong, the unexpected NICU stay, and the lonely spiral into anxiety that followed. Despite having all the “right” tools and training, she still found herself drowning—and clawing her way back with the help of a village, EMDR therapy, and her own stubborn refusal to give up.

We talk about shame, spirituality, radical acceptance, and the way our culture fails new parents again and again. Kara also shares the beautiful story behind her book Mama’s Thoughts—a children’s book secretly written for mothers navigating the storm.

This episode is a reminder that preparation doesn’t always protect us, but connection can heal us. Whether you're a parent, a provider, or somewhere in between, Kara's story will stick with you.

🗝️Takeaways

• Kara's journey to motherhood was influenced by her background as a caregiver.
• She highlights the challenges of navigating pregnancy during the pandemic.
• Kara experienced a traumatic birth and the complexities of postpartum recovery.
• She discusses the stigma surrounding mental health in the perinatal period.
• Kara advocates for the importance of recognizing PMADS in new parents.
• She shares her personal experiences with postpartum anxiety and OCD.
• Kara stresses the need for better support for birthing people in healthcare settings.
• She highlights the role of support systems in managing mental health challenges.  The importance of having a supportive community during difficult times.
• Shame surrounding mental health issues often stems from illogical beliefs.
• Medication can be life-saving and should not be stigmatized.
• Finding the right therapist is crucial for effective treatment.
• Community support can significantly impact healing and recovery.

🔊Sound Bites

• "I had a journey to get to where I am today."
• "I was very anxious to do that."
• "It was a baptism by fire kind of experience."
• "I had postpartum anxiety, postpartum OCD, and PTSD."
• "I was terrified to say anything about it."
• "I had a flashback and I was so overwhelmed."
• "I was fortunate I had my sister."
• "We should stop at nothing to take care of ourselves."
• "We are promised a village. Where's the village?"

Transcript

Chelsea Myers (01:09)
Hello! Today I'm here with Kara. Kara, how are you?

Kara Kushnir, LCSW (01:14)
doing pretty good, you know, Monday morning, hanging in.

Chelsea Myers (01:17)
Monday morning after Easter. It's early. I'm glad you're hanging in. It was a little bit of a rough start for me getting up this morning. So more power to you. Kara, I'm so excited to finally connect with you. I have a whole list of things that I know about you, but rather than me read them off a piece of paper, it'd be super awesome if you could introduce yourself.

Kara Kushnir, LCSW (01:26)
Yeah

Chelsea Myers (01:44)
to my listeners and let them know who you were before you became a mom.

Kara Kushnir, LCSW (01:49)
Sure. So my name is Kara Kushnir I am a licensed clinical social worker and a perinatal mental health certified practitioner. I'm a mom of one. And before I became a mom, I had worn many hats already. So I think that just like adding the mom hat was an extra, I think probably the biggest hat any of us can wear. And it comes with like almost sub hats, I guess, so to speak. But I've always been a

Chelsea Myers (02:10)
You

Kara Kushnir, LCSW (02:17)
I've always been someone who's really invested in people and relationships. And I think that motherhood just exploded that in different ways for me and made me look at things in nuanced ways. As well as in the work that I do, I was a therapist prior to having a child. But I think that becoming a mom and watching other people become parents around me really sort of amplify the direction that my therapist hat took me.

Chelsea Myers (02:43)
Yeah, I love how you describe that too. It's like the hat with with like mini hats. I'm picturing like branches off the hats like we Yes. Yes, exactly. and you're also an author, you're an author, you wrote ⁓ Mama's Mama's Thoughts, if I could speak, that'd be cool. ⁓ which is an incredible book that I've talked about on social media, and I'm so glad that it exists.

Kara Kushnir, LCSW (02:50)
Mm-hmm. Yeah, it's like Russian nesting dolls, like, also.

Mm-hmm.

Chelsea Myers (03:13)
and you, yeah, and you are, you work for PSI.

Kara Kushnir, LCSW (03:13)
Thank you.

Yeah,

it's a volunteer. So I currently am the chair for New Jersey for our state chapter here. And I do within that a lot of different things supporting other roles and work in our chapter. But a lot of it is related to education and training, advocacy work, working on a really cool project right now. That's a grant project and doing a lot of work on focusing on underserved parents and parents really where the needs exist around BIPOC mental health and

acknowledging the experiences of people who don't fit like the mainstream white heteronormative cisgender example of like motherhood. So it's exciting to do that kind of stuff because it's just as important as everything we see in the mainstream.

Chelsea Myers (03:58)
Yeah, yeah, it 100 % is and that deeply resonates with me as a non-binary

did you always picture yourself being a parent?

Kara Kushnir, LCSW (04:08)
That's such a good question. And I've heard you ask this before. When I was coming into my office today, I was like, she's probably going to ask me something like that. So I have to be prepared to think about it because it's such a deep question. And it's interesting. I've been asked that before. And I could say yes and no. ⁓ I felt so interestingly, one of my other hats that I wear is I'm a sibling to a young adult now, a sister who has intellectual disabilities, autism. So I was already very much a caregiver from a very young age. I have a very long

history in childhood, adolescence and adulthood of being in some sort of capacity of feeling maternal and sort of having that role. And I always knew I wanted to be a parent, but I also really enjoyed the time before being a parent not having to take care of anybody else. so I think that that was something that I had to really reconcile with of making the decision to be ready to say, OK, well, now I do want to move into this phase of life and I do want to have a child or children, whatever the universe allows me.

But I also want to feel like I've had time to myself to be ready for that ⁓ because I knew my life would be forever changed just having the experience of being a caregiver as a kid, you know, in a sense.

Chelsea Myers (05:18)
Yeah, absolutely. Do you feel like you were able to have that time to sort of explore yourself outside of that role?

Kara Kushnir, LCSW (05:25)
Yeah, I do. think that I think college, especially like going away from home was very important to me just to be on my own. It was kind of interesting watching my peers just be like, this is like what we do. And I was just so excited and happy to like only have to take care of myself. And I think that it was a unique lens that I looked at the world through. But I definitely felt that way. I my husband and I waited to have children until I was 30 when I had my son. And I had really felt like I had

made sure I was in a place of feeling prepared. I also, interestingly, felt like I was almost like the clock was ticking in a weird sense of like we waited longer because of COVID. And then we kind of were trying to make things work and then kind of realized we can't keep waiting. Like it's just this isn't something that is fair to us and we have to kind of try to figure out how to live our lives. ⁓ But yeah, I do feel like I had enough time to do that. I also feel like there's never enough time to yourself as a human being. So

Chelsea Myers (06:05)
Mm.

Kara Kushnir, LCSW (06:22)
While I felt prepared, I don't think that it will ever be like I felt so truly ready. I don't think anybody's ever like, I'm ready. And I know exactly how it's going to go and exactly what I'm going to do. And if you feel that way, that's great. But also you could be setting yourself up for a little bit of not being so successful because that's not really fair or realistic, in my opinion.

Chelsea Myers (06:42)
I would agree with that opinion. I think the biggest loss of control is becoming a parent. You really do hand over so much control. ⁓ I mean, you gain a lot too, but in a lot of ways you lose a lot. So what was that journey like for you when you decided, okay, I'm not going to wait for this global pandemic to hold me back any longer? ⁓ What was the journey into the parenting process?

Kara Kushnir, LCSW (06:52)
Yeah.

So I'm also like more of like a, I guess like a spiritual person. So I actually lost my grandfather in September of 2020 during, so, you know, we're in the pandemic now for a while, but things were still very much under control in terms of where we could and could not visit and what was happening. We were fortunate enough to be with him and I was with him when he passed in the hospital. And I remember that experience kind of this reminder of, you know,

when we lose people as a reminder of like, okay, well, what's really important in life? And I think that that coupled with my husband's grandfather had passed the day actually we got married and we didn't know because he was in Ukraine. So we had no idea. Everyone kind of did not tell us until after because they wanted us to not have to be sad. So they kind of kept that under wraps until a few days after we got married. But I think the experience of going through that together and losing two very important people in our lives.

we kind of took that meaning and sort of said, okay, well, relationships are very important and we really valued so much of the relationship we got to have with these two people. So why, you we can't wait forever. Let's just do what's gonna work for us and be as careful as we can be. Being someone who is highly, has always been very highly anxious, I was very anxious to do that. ⁓ There was still so much uncertainty. This was like,

pre-vaccines, pre anything kind of coming to fruition around clarity on what we're gonna do here. And we were still very much in like lockdown mode in a lot of respects. So it was very scary. was working at a school at the time as was my husband, he still does, he's a teacher. And I kind of just decided that I was gonna do the best that I could, but becoming... ⁓

Chelsea Myers (08:32)
Mmm.

Kara Kushnir, LCSW (08:53)
you know, going through pregnancy at a very rough pregnancy and actually working in a school and needing and requesting accommodations was not met well. So I ended up resigning from my job four months pregnant. And then I took my part time private practice that I was doing after school hours during school. I was on a child psych team working with kids with disabilities and IEPs. And I loved it. But it was just so much need for me to meet even physically when paraprofessionals were out. I was going to classroom. So I was like, I can't keep doing this. I'm throwing up.

Chelsea Myers (09:20)
Mm-hmm.

Kara Kushnir, LCSW (09:22)
constantly all day long every day during a pandemic in a public bathroom. Like this is not working and I'm feeling so sick. So left that and then took my part-time gig full time and I never looked back. But it was really like a baptism by fire kind of experience with deciding and then everything that happened and followed suit was very like unexpected. A lot of the things that could go wrong did go wrong kind of a thing. So it was very challenging for sure.

Chelsea Myers (09:39)
Yeah.

Yeah, I can say I can say I not only can imagine that I that's almost the exact experience I had with my second I was teaching, I was teaching we had just come back from COVID I had asked for accommodations, they were not being met and I couldn't I was I wasn't a special educator. So like so that again, different podcasts different subjects, but like getting our needs met in in ⁓ jobs that are serving others. ⁓

Kara Kushnir, LCSW (09:58)
Hmm.

Right. Yeah,

Chelsea Myers (10:17)
yeah, it's

Kara Kushnir, LCSW (10:17)
and a female dominated profession and just female facing people also looking at birthing people. It's wild that we're doing nurturing of other people's children, but we're not being taken care of in any way really. And it's really sad, honestly. And it's no coincidence even now as therapist, a lot of my clients are teachers. So I find that really interesting.

Chelsea Myers (10:36)
Yeah.

Yeah. That is, ⁓ well, I'll have to chat with you again. I'll send you another message because I have another podcast that this is the perfect topic for. But, anyway, moving back to your story. So you stepped away from the school system. You were experiencing some challenging pregnancy symptoms just in general. You were already feeling burnt out. And things got complicated. Things didn't necessarily get

Kara Kushnir, LCSW (10:43)
You

Chelsea Myers (11:04)
easier. Can you sort of talk to me about that a little bit?

Kara Kushnir, LCSW (11:08)
Yeah, I mean, I remember even just like during the pregnancy, the dystopian feeling of like going into a grocery store with like a mask on and just like in gloves or like not being sure. like, I remember like putting my hand on my stomach and just being like, I hope I'm doing the right thing all the time. It was such a breeding ground for doubt and ⁓ to be anxious and unsure of yourself. And I look back now and I think about, yeah, that was kind of traumatic. Like that was, you're already loaded for

But it cascaded into there from birth and postpartum and all those things. And the experiences I had, I had postpartum anxiety, postpartum OCD, and PTSD. So just like kind of navigating it. makes a lot of sense even just knowing what pregnancy was like. But yeah, even like leading up to who's gonna be allowed in the hospital just planning for birth, I had planned for a vaginal delivery all along and then ended up having to schedule a C-section. So there was a lot

a lot of uncertainty throughout the entire piece. I think that's exactly, it's funny, it prepared me in a sense to kind of have to, I talk about surrendering a lot and the idea of that. And it doesn't have, you I don't wave my white flag like I've done and I can't do this. It's more of like I yield to, I cannot control, therefore let me find my way to stop fighting the water and either float in it or swim parallel to shore. a lot of, I use a lot of.

Chelsea Myers (12:12)
Mm-hmm. ⁓

Kara Kushnir, LCSW (12:27)
water as a metaphor. And I think it's important in the sense that we often try to fight that current, but it can suck you in. So just kind of trying to figure out how to surrender and be to get back to shore make peace with the water that it's not bad. It's not trying to hurt you, but sometimes it's ebbing and flowing just as we are. And so how do we figure that out? But yeah, it was a ride for sure. And I had to learn how to surf.

Chelsea Myers (12:50)
yeah. And it's bringing up it's bringing up a particular DBT skill that I still struggle with and radical acceptance like and it really is that like, okay, it's not that I'm saying like, okay, I give up, but it's like, okay, this is what's happening. And I'm either going to sink or swim. And yeah, it's something that I still struggle with. But it also brings about this point that you you experienced trauma you

PMADS as well. And you are a mental health professional. We've talked about this on the podcast before. Mental health professionals are not immune to mental health issues, mental health challenges. I think even before we get into how you approach that, because like you said, you were mentally preparing, you kind of had a general idea of what could happen in terms of your mental health, your birth experience,

and how that changed from what you envisioned. How did that unfold and what did that do to your kind of vision of what this whole experience was gonna be like for you?

Kara Kushnir, LCSW (13:57)
Yeah, ⁓ it's interesting. absolutely think it's a common experience amongst mental health professionals is this sense of like, are absolutely not immune, but I think that sometimes we don't talk about it. And it's this weird fine line we walk with like self-disclosure, even like having these kinds of conversations. But I think that what I've taken from it and why I have these conversations is to destigmatize and commonize. I like to say not normalize because a lot of the stuff shouldn't have to feel normal, but that it does happen. ⁓ But yeah, I

I ended up at 37, 38 weeks roughly. I scheduled my C-section for 39 weeks because I knew I was gonna have a very big baby. And I was really terrified of shoulder dystocia and did not wanna take the risk. And I'm glad that I did in the sense that my son was nine pounds, 10 ounces. So it would have been a very rough experience potentially. And I had back issues and other things that might've made it challenging for me to birth. for belly birth made sense, but it...

Chelsea Myers (14:43)
Woo!

Kara Kushnir, LCSW (14:53)
I unfortunately, I had a lot of things go wrong as far as anesthesia not working effectively with pain management, needing to be put under general anesthesia because I could feel things I shouldn't have felt. So that in and of itself, I think is a common experience. A lot of birth trauma survivors saying I didn't feel safe. I didn't feel heard. When I was speaking up, I felt like I was being minimized. That's something that I also experienced, unfortunately. And I think this sense of not feeling control, it...

Feeling like you're kind of trapped, I think, is a big part of that too, especially if you have some sort of anesthesia, spinal epidural, and you can't move. That certainly can be a part of But even just after that, so my son was born, I was put to sleep, and then I met him in recovery very briefly, and then he had to be taken to the NICU unexpectedly. So I have this huge baby, and I'm like, why does he need to go to the NICU?

And it was a very common experience of a C-section baby would just retain fluid in the lungs and get some jaundice. So it made sense, but I was really thrown for a loop and I couldn't have visitors. So again, being still very much heavily stoked in the COVID ⁓ era of restrictions, I sent my husband to go with him and I went upstairs and my doula snuck upstairs with me, even though she wasn't supposed to, because she was like, well, we're not letting you go by yourself. But...

Chelsea Myers (15:47)
Mm-hmm.

You

Kara Kushnir, LCSW (16:09)
Then she had to leave and I was alone. And I actually remember looking out the window in the hospital and I was like, what just happened? And I was processing what had just happened and where I was and what was happening. And I said, my gosh, I was so prepared. I thought I had done all the classes and read all the books and done everything, quote unquote, right. And I still had a traumatic birth experience and I know what's happening to me, but so many other parents, they don't know what this is. They can't name this. They think it's them. ⁓

was really overwhelmed, but I also, I think I also felt like angry and kind of like, this isn't right. And it kind of really motivated me further to want to do this work. I had already been more aware of this than I think a lot of other practitioners, because no one touches upon this in graduate school when you go to become a therapist, which is fascinating when it's such a universal experience of like, this is how we have humans, but I digress, you know, we don't, we don't take care of women's health at all enough in this country. So that's a whole other, that could be a whole other podcast episode, but

Chelsea Myers (16:53)
Yeah.

No.

Kara Kushnir, LCSW (17:07)
But I feel like it's interesting ⁓ just in the sense that I knew what was going on and I've been aware of this from my colleagues even working in schools and having a lot of berthing people around me. It still happened to me and I was like, okay, well, I need to make sure that I take care of other people. I think that was sort of the beginning. I ended up having from that.

More medical complications. had wound care for eight weeks at my house. Somebody had to pack my C-section incision every single day because I had such a bad wound. That was very traumatizing. And of course, there's like no pain management. It's just like you're lying on your couch on a chuck pad and there's a nurse like doing that. So that was wild. And I really couldn't take care of my son. I was like really struggling to take care of myself. So again, a lot of trauma survivors will talk about feeling inadequate,

Chelsea Myers (17:35)
Mmm.

Kara Kushnir, LCSW (17:57)
their body failed them, that there is a sense of disenfranchisement of experience. And that's very valid and real. I think a lot of what I try to instill in people preparing to have a baby or even after is you can do everything right and it can still happen to you and it's not your fault. And I think that's the hardest thing for people to work on acceptance of. It's how I got so invested in ⁓ being trained in EMDR and I do that now as a big focus of my work.

Chelsea Myers (18:13)
Okay.

Yeah, there's a EMDR has come up a lot more recently. So we've been doing the podcast now for almost two years and EMDR in the last like six ish months, people are like, I'm really getting into EMDR. Like, cool, like I need to learn more about it. But it just seems to be something that people and mental health professionals are exploring more in terms of birth trauma, ⁓ which I find really interesting. So through that,

through birth trauma and through your recovery period, which is traumatic in and of itself, when did you start to, or did you start to notice the signs of PMADS, like the anxiety and the OCD? Was it you or was it someone else who sort of picked up on it?

Kara Kushnir, LCSW (19:05)
Yeah.

It was both. I noticed it right away, but I didn't want to say anything about it because I was terrified. I do remember being in the hospital and I couldn't sleep and I was so amped up. And I now know it was because I also had so much blood loss that I had postpartum anemia, but no one had actually come out and told me that, so I did not know. And when you have really severe anemia, it can affect your breathing. And I felt like I wasn't breathing. So when I would go to sleep, I would start awake because I felt like I was going to stop breathing.

And I remember asking a postpartum nurse, I was like, please find the attending. I am not drug seeking. I need an Ativan or like a Xanax. Like I need something. I can't sleep. And there was such fear of giving me medication and like, how's that going to affect me? And I was like, well, if I don't take it, then I'm not going be able to do breastfeeding or anything. So we should probably figure that out. And also my son's in the NICU right now. So this is a moot point. Like I was just...

very aggravated by that. And I think ⁓ I noticed even then just that sense, but it was so early on, I was like, okay, first two weeks, I can expect this. ⁓ When I went back, so I got discharged from the hospital at day four with my son, fortunately, two days later is when I started to really feel like I couldn't breathe. And again, still was not aware that I had this postpartum anemia. My twin sister is also an LCSW and a PMHC. She's, ⁓

took me to the hospital to get checked out because we weren't sure if I was having pulmonary embolism or something else. And I remember walking into the hospital and I smelled that like Lysol cleaning smell that I remembered. And I went into a full-blown panic attack and I had a flashback. And I was so overwhelmed and my sister immediately noticed it and she named it and said, you're having a panic attack. I think that you just had a flashback.

Chelsea Myers (20:42)
Mmm.

Kara Kushnir, LCSW (20:52)
it's OK, you're safe. Like she was really trying to really orient me to where I was, that she was with me. ⁓ And to the point where they finally hooked me up to an EKG and they were watching me and she was sitting with me and she her hand on me she was like, you can sleep. If you go to sleep, you're not going to die. I promise I'm right here. And like that, she could just see how I felt so scared. ⁓ And then after that, she was the one noticing I was tracking every single ounce of food that my son was eating and I was perfectionist about how clean things were. And then

I would have these intrusive thoughts about him not breathing in his car seat. So I was pulling over every five to 10 minutes and checking him and then getting back in the car. And so she was the one that actually named out loud. I really think you have posed part of OCD. And it's interesting, I'm also, I'm very, as a clinician, very ⁓ fascinated by and really in tune with, I think because of my own lived experience, the intersection of OCD and trauma, especially in the perinatal period. ⁓

Chelsea Myers (21:46)
huh.

Kara Kushnir, LCSW (21:48)
And I've worked with so many parents who've had that intersection. But I think it's when I was going through treatment, I had seen a couple of different therapists when I was postpartum. And some of them trained in perinatal mental health, but not trained in OCD. And they missed it. And so it took quite a while to get help and to work on it. I did eventually. ⁓ I'm also a big advocate for ICBT, which is a newer treatment method for OCD.

ERP is heavily discussed and I think it's a great and is the gold standard of treatment. But ICBT does not require exposures and therefore might be gentler to new parents who are like, I really don't want to hold a knife sitting next to my baby when I'm having harm thoughts because that might be very traumatizing, but I can, you know, work on it a different way. And so that's something I've been really interested in. But yeah, it was really a combination of like I had the knowledge to notice it.

and even still didn't want to say anything. But I was fortunate I had my sister. I have a colleague who works at my practice who was a PMHC long before I was who ⁓ noticed what was going on. She was trying to mitigate the trauma. I remember when I had to have the home care, she actually called the hospital system and the home care director because she knew them and said, by the way, the doctor only put it in for three days a week and wants her husband to do the wound packing the other days, which is absolute bullshit. So.

Chelsea Myers (23:05)
⁓ yeah.

Kara Kushnir, LCSW (23:06)
figure that

out. And so she called them and advocated for me and I ended up getting somebody to come every day because of her. Like, so I had people who knew what risks could occur, what could happen to me, who were naming it very gently. ⁓ And also just like seeing me like sitting there and fall apart and they didn't shy away. I think that the willingness to sit in the darkness was what helped me come out of it because there were people who noticed but they didn't know what to do or they they didn't know what to say or were afraid to say the wrong thing and I could feel them turn away. And I think that

turning away from or sort of distancing amplified the stigma. And so the people who ran into the darkness instead of ran away, I think that made the difference of me being able to finally acknowledge it myself.

Chelsea Myers (23:49)
there's so many good points that you hit on in your own experience and talking about like knowing the risks and knowing well even prior to that, that they don't talk about this in, ⁓ this is not the right term, but like therapist school. When you're going through your mental health training, they don't talk about PMADS or if they do, it's a blip. It's a day or less than a day. ⁓ It's a subsection of a chapter I've heard. And it's such

a huge problem, especially in our country. I'm not saying the problem is with birthing people. The problem is that people are experiencing it and their needs are not being met because we don't have enough trained professionals to meet the needs. And even you and your twin sister who had somewhat of a background in this and had the knowledge, you still felt that shame.

And I think that that speaks to the fact that the shame comes from someplace different. It's not logical. because when you're in that state, logic doesn't really exist. You have that little voice in the back of your head saying like, okay, this is crazy. But the louder voice is saying, no, I have to do these things, or I have to worry about these things. And, and like you said before, like, that's not normal, but it's so common.

It's so common. And you had an incredible supportive community. Like you said, you had some people who shied away, but you had some people who really sat with you in the darkness. When you noticed the shift and you noticed the change, what steps did you take to sort of address it and was having that village beside you part of that process?

Kara Kushnir, LCSW (25:30)
Yes, ⁓ definitely. the first actually truly funny, the first thing I did was one of the only things I felt I could control was when I was in the hospital, I called ⁓ my psychiatrist than I knew. And I said, hi, I an appointment with you because I don't know what this is going to look like. But I want you on standby so that I'm not waiting a month or so plus for an appointment in case I need medication. And I think that that is something that a lot of people.

are so nervous about, and I do a lot of educating about, of the safety and efficacy of medication and that it can be really life-saving. And we look at that cost-benefit analysis. I was very much in the mindset that if I am not OK, then how do I take care of this little human? So I need to take care of myself. I think that was really important. I think also I was very open with my partner. I'm very fortunate that my husband, I think, just, unfortunately, he was just as shell-shocked as I was. He did not, I think, the support he needed until much later. And it's something that I'm

very vocal about and he will acknowledge like ⁓ PMADS affect everybody. So like we 100 % look back and I'm like, I think you had postpartum depression. And he's like, yeah, me too. I really think so. Because he was doing everything when I couldn't do it. And he's taking care of this new baby. He's a first time parent. His wife is an absolute mess and he doesn't know what to do for her either. He's not a mental health professional and he's just trying to keep everything afloat. That's incredibly overwhelming. So I think that

Chelsea Myers (26:32)
Yup.

Kara Kushnir, LCSW (26:53)
But being able to talk to each other about it and not shy away from it and it not feeling like a stigma, that was massive. The sense that we could both be in the same storm in different boats, but acknowledge each other was very important. And I think then also the fact that I had people naming it and naming it not in a way of like, ⁓ like, I think you have postpartum depression, but like,

Hey, like I see you, this is so hard, you're not crazy. Also, we're gonna help you, let's figure out what we're gonna do to help you. I think just the nurturing that I received, ⁓ my sister was over all the time. I'm so fortunate because she also works in a school during the day and then she works part-time for me after school. So she was off in the summer when I had my son. So she was like over every day. She was offering to do laundry. She was like doing the actual things that helped us function. And it wasn't like, I'm gonna hold the baby, you go do things.

Chelsea Myers (27:36)
Thank

Kara Kushnir, LCSW (27:47)
I can do and then naming things that she could do so we didn't have to come up with them and then, and, and, or I can also hold, you know, my nephew and you can go sleep or take a shower, but if you don't feel comfortable or if you want to hold him, I'll do, I'll do everything else. Like, what works for you today? And it was very much an opportunity to show and receive at the same time for both of us that I think helped me continue to move forward. I did seek out therapy and I, and I also,

didn't stop seeking out therapy until I found the right therapist. And I think that is really hard. ⁓ And I will say that to you is to say, I know people struggle to find the right therapist. And like even people who might come see me or someone in my office, like we might not be the right person for you and that's okay. Like you're supposed to get the person who really can best meet your needs from a relational standpoint, you feel comfortable with them, but also they have the expertise to meet you and treat what you need treated and support that. But I met people who I felt like were

Chelsea Myers (28:16)
Hmm.

Kara Kushnir, LCSW (28:41)
doing a lot of talk therapy and that really wasn't what I needed. It felt like we were circling the drain with the OCD and the trauma. And so that's what made me seek out an EMDR practitioner. That's why I got trained in EMDR because it's such ⁓ a bottom up, a body and brain connected treatment modality that I felt like it was experiential enough for me to take the armor off, to be present, to really dig into and process in a more adaptive way.

that helped me shift my experience and my story of myself in that time. And I've continued to seek out practitioners who do a lot more integrative internal family systems theory, ⁓ somatic-based work, things that are a little bit more ⁓ body-based because if you think about it as a birth trauma survivor or someone who goes through perinatal trauma, it is in your body. So we need to address that from a body-based perspective. That really moved mountains for me.

Chelsea Myers (29:30)
Mm-hmm.

Kara Kushnir, LCSW (29:34)
and finding community, talking to other people, whether it was on an online group, it was on a Reddit thread, it was in a support group for PSI, it was virtual or in person, it doesn't matter. that all, it's a culmination. think that it's not one thing. It's not like there's this smoking gun that's gonna help you get through PMADS by doing this one thing. It really is finding this culmination of multiple pieces that fit together, that speak to the needs of the person. And that's what really changed my trajectory was

I didn't stop reaching out. I didn't stop until I found what worked for me. And the tenacity that moms have to take care of their children, if we turn that a little bit inward, can dramatically improve our own outcomes. We would stop at nothing to take care of our children. We should stop at nothing to take care of ourselves. And I think that's really what I look back and can say I did. And it made a difference, for sure.

Chelsea Myers (30:21)
Mm-hmm.

Yeah, so many things that you talked about. ⁓ My brain just pinged and pinged and pinged. And it's one of those situations again, where it's like, God, if we had hours but like, this, this sense of like you just said, like, we would do anything for our kids. And I think there is this stigma and shame when we think about PMADs that it's like, well, the mother's not bonding with their baby or like, what is what's going on with them? They have a healthy baby, why can't they feel happy and ⁓

And that's, that's not, that's not helpful. A and B that's not nine times out of 10. That's not the case. Like it isn't, we are either incapable of caring for ourselves and our kids because of what's going on in our bodies, or we are over acting. Like we are, we are caring so much about our child and in ways that, that seem and can

Kara Kushnir, LCSW (31:10)
Yeah.

Chelsea Myers (31:26)
like with OCD, like checking if your baby's breathing every three minutes. ⁓ So I think the stigma and the shame attached to that is really hard and it does get in the way of lot of parents seeking help. I so appreciate you mentioning that your partner also struggled with postpartum depression. ⁓ We've talked to a few dads now who have experienced it. I think the stat is one in 10 still, but I bet you it's much higher, just like with PMAID.

Kara Kushnir, LCSW (31:52)
Mm-hmm. But me too.

Chelsea Myers (31:55)
Yeah, I think it's much higher than one in five for birthing people as well. But um, but yeah, you hit on so many good, good points. And the things that helped you, the things that saw you through are things that we are sort of promised in the mainstream media, but but aren't what we actually receive. We're promised a village. Yes.

Kara Kushnir, LCSW (32:19)
Yeah. Mm-hmm. Yeah, where's the village?

Chelsea Myers (32:25)
We're promised a village. We're promised this beautiful experience of like, we hear about the golden hour and we hear about the fourth trimester and the bonding and the giggles and the skin to skin. And that happens for some people. That happens for some people. But I do feel like it can come from a place of privilege if you have a built in support system already. Yeah.

⁓ and I'm thankful and I'm happy that you had the support system that you had and that you had the knowledge that you had because that's ultimately what saw you through. And correct me if I'm wrong, because I could be completely off base, but I would assume it would help with that sense of hopelessness and maybe more a feeling of frustration. Like, I, what, what the hell? Like,

Kara Kushnir, LCSW (33:23)
Yeah, yeah, well, and 100%. I think that what's so tricky and it's so interesting because when I work with pregnant individuals and I'm fortunate enough to get them during pregnancy, we can ultimately in some ways potentially change the trajectory of their postpartum experience because we can start to identify and build things in. And not everybody gets that because whenever when I talk to people about postpartum, I say having a baby is much like when people decide they want to get married. They focus on the party and the wedding and they forget about the marriage. It's the same thing when it comes to

Chelsea Myers (33:24)
Yeah.

Kara Kushnir, LCSW (33:53)
this, but it's resources, right? Like I live in an area of the country where I had a lot of access. I am fortunate to have really good health insurance. I am fortunate to have people who identified and were willing to show up. was, I had done work on myself prior to this where I felt capable of asking for what I needed. So my emotions could be action oriented and that's where the anger and frustration could be really beneficial. Like I could use that to speak up and seek out. And I think

That is not the case for a lot of people, if not the vast majority, especially in different parts of the country. And it's a problem. 100%, I think, I do think that if we studied and I think the more that we're doing work to identify and acknowledge disparities and care and outcomes, it would be a fascinating study worthwhile around who does better and how their status and privilege impacts their ability to do better, because it's not anyone's fault. I think that's really a massive part of that is to acknowledge it directly head on.

Chelsea Myers (34:46)
No.

Yeah, yeah. And again, I feel like I'm going to say this a million times, like another podcast or another time, but like the situation isn't getting any better with where we are right now. ⁓ And we know that marginalized communities and the BIPOC community especially are affected far more than those of their white counterparts when it comes to ⁓ maternal mortality and infant mortality and PMADs and all of those things. So like we know these things.

We know these things, just need the action. And I love that you're an advocate for these things and that you are actually fighting to make change happen. ⁓ And to sort of weave us back into your story, like when was the turning point for you? And during this as well, like you said, you were sort of hypervigilant with your son. Like, did you feel like...

you were able to connect with him while you felt kind of disconnected to yourself.

Kara Kushnir, LCSW (35:53)
It's great question. So to the first part, I feel like there was no a-ha turning point. And I think that's so important that I say that because I think we're always looking for that feeling of this miracle or magic thing that happens and we're OK. I think that it was over time and consistency noticing, ⁓ I didn't do that today. I didn't check that. I didn't perseverate on that, that sense of being able to notice and shift.

had to work really hard to connect with my son. And it's so funny because I think that that's common regardless of your mental health status. Like I've said, that's a new parent. So I'm like, yeah, I remember taking, I remember sitting across from my son in the car seat and looking at him. We were leaving the hospital and I looked at my husband and I was like, we're allowed to take him home? Like whose baby is that? And he was like, I know, this is so weird. And it was like, and we, took time to form a relationship with him and that's okay. I think that's so many people to what you mentioned earlier, if they don't get like that, like,

Chelsea Myers (36:39)
Haha

Kara Kushnir, LCSW (36:51)
like movie esque moment of just I'm so in love with my baby and like and I got that skin to skin like that's great if that happens to you and it's you're okay if it doesn't happen to you. It doesn't mean you're broken and it doesn't mean that you're not gonna feel that bond. It's just that it might not happen right now or this way and that's okay. There's a lot of potential reasons for that but you know relationships take time and I think I had to work really hard and intentionally. I do think that I often going back to this like part of me that I

have the spirituality thing. Like I really looked at him and I remember just like talking to him and like, and the way he would look at me or like the responses I would get and like, it would be this like little affirmation, but like no matter how hard I was feeling, how hard it was for me or how poorly I felt I was doing, he just saw his mom. Like there was no judgment, there was no fear.

Chelsea Myers (37:37)
Mm-hmm.

Kara Kushnir, LCSW (37:40)
And he felt safe. And I think actually my ability to pick up on that and sort of reframe in that way is what helped me to come through and to develop connection and to show up for him. It's ultimately what helped me write my book was that perspective.

Chelsea Myers (37:53)
I was just I was perfect. I was just going to bring up the book. I was so at what point in your like you said there was no aha moment. It was a gradual like noticing of things. At what point did you kind of say I need to write about this and had you thought about writing a book prior to this?

Kara Kushnir, LCSW (38:13)
Yeah, I actually have a different book that I wrote that I, when I was a kid, ⁓ it's a whole other topic about just like having a parent with cancer, but like, and that's like something I've had on the back burner for so long. This was my, I worked on this very quickly, just about a year ago, I started working on it. And I wanted to find an illustrator who I felt could speak to the vision I had in my head. And I ended up, I was very excited, my illustrator. ⁓

is a mom of four herself. she so it was really fun to have a mom illustrate this. But she talking with her was really exciting, just in the sense of like why I wanted to write it. And I decided to do it, I think, because not just my own experience, but I wanted the the book to reflect varied and nuanced experiences. When people look closely, they'll notice ⁓ I have different nationalities represented and races. I have a same sex couple in there. Like, I really wanted it to just be reflective of

all the different experiences. But most importantly, I think I wanted to write something that people could actually read when they're sleep deprived. And the idea of picking up a book or like, or going to a group or something might be really tricky, just something that they could, okay, well, I'll read to my baby, I'll read to my kid, because that's something we're all willing to do. We will give to our children all the time. ⁓ So it became a book for moms, but it's really in disguise as a children's book. And so that was really the goal. ⁓ But when I was writing it,

Chelsea Myers (39:23)
Yeah!

Kara Kushnir, LCSW (39:36)
I was thinking about my clients. was thinking about people's stories and people who had shared with me and then my own experiences and I wanted it to represent them. ⁓ And so it's really informed by all that has been shared with me in a very short period of time over a few years just kind of to come together to make this. But I don't know, I just kind of decided like I needed to do something and it was a small way to make an impact and to make something tangible for folks that they could keep. And ⁓ it's really exciting because I people tell me like,

I give it to people at their baby shower. Like I give it, so, I, which I love, I think that's such a good idea. It's like, I'll bring them like a door dash gift card and I bring them the book when they're having a tough day. And it's like a gift because I think that it's also a way to start the conversation that nobody wants to have. And it's a lot of the parents that I've spoken to that are like,

Chelsea Myers (40:07)
Yeah

Mm-hmm.

Kara Kushnir, LCSW (40:25)
They're a little bit farther removed from this time. When they read it, they like I've had people who were like, I sobbed reading your book because I needed this when I was there. And so I now get it for everybody because I don't want somebody to not feel to feel I want them to not feel alone. There's resources in the book. There's journal pages just if you want to jot something down. Like I wanted it to be just but not an overwhelming resource, but like a bite. And I think that's kind of why I sat down and just start working on it.

Chelsea Myers (40:52)
Yeah, I was so grateful when you reached out to me and were like, can I send you this book? was like, yes. First of all, I'm book obsessed, especially children's book obsessed. ⁓ My husband says that we have too many books. say that the limit does not exist. ⁓ But I did, read it with my, so I have a two year old and a nine year old. And I read it to my two year old at the time and she was one, I think when I got it. ⁓

Kara Kushnir, LCSW (41:02)
you

Chelsea Myers (41:21)
And she didn't really get it, but I read it with my nine year old and it was this really amazing moment. She watched me go through so much. ⁓ And so she carries her own trauma too. But to be able to read this and she's like, did you, did you feel like that? Or she can point to a particular page and be like, I remember when you, you said that, you said that. And I'm like, yeah. And she's like, ⁓

And it was this great connection moment. She's super empathetic anyway. I don't know what planet she's from. I don't know how I birthed this child, but she's the most empathetic person I know. But for us to be able to read it together and for her to see these things and see that other families go through think that helped her process some of it as well. Yeah. like, highly encourage parents to check out the book.

I've talked about it on Instagram. It's going to be linked in your show notes as well. But I did, I loved the perspective and I loved the approachability of it. I loved, it's a picture book. It's a picture book. It's a picture book for mom, but it's a picture book for families. Yeah.

Kara Kushnir, LCSW (42:37)
Yeah, mm-hmm. Yeah, the older sibling

piece is so important. I have a friend of mine who, she has children who are five, three, and just under a year, and she was reading it to all of them, and her oldest said to her, ⁓ is that why you cry sometimes? Is that, and she was like, yeah, like, and she's like, and she's like, that must be really hard, or like, and then sometimes, and then actually like affirmed for her, like, but mommy, you do a really good job. And like, I think that like,

Chelsea Myers (43:05)
Yeah!

Kara Kushnir, LCSW (43:06)
just

being able to hear that like it's like that is what our kids think of us like they 100 % think we are the sun, moon and stars. They do not see us even in our darkest moments is anything less than and so it is really helpful. I think even if you're reading it to like a six month old who has no idea what you're talking about, like you're really reading it to yourself like it's a reminder when they're sitting in your lap like, oh, you think that about me, you don't think this stuff, you're not worried, you're not scared, you're not, you know, hurting. And that is a really

Chelsea Myers (43:22)
Yeah.

Kara Kushnir, LCSW (43:34)
I think present orienting message that people need sometimes to come out of their head and come into that reality of like, this is your reality happening right now. You're doing the thing you think you cannot do and you're doing it much better than you're probably giving yourself credit for. So let's keep going. And it's a really important, I think thing people can start to shift in their own self-talk.

Chelsea Myers (43:53)
Absolutely. It's an incredible resource. It's an incredible tool to have in your toolbox. I love that you say people are giving it as a baby shower gift because I don't know anybody having a baby right now, but it is it's one of those things that I'm like, this may not happen to you. But if it does, you can have this you can just it could just be on your bookshelf. ⁓ there's so many things that we could talk about. But for time's sake, I'm going to wrap this back around. So in terms of your journey,

There's obviously pieces we didn't touch on and there's things that we didn't dive deep into. and like you said, you've listened to a couple of my episodes. This has been happening a lot lately. I usually end on one of two questions. I haven't liked either of them lately. The people that I'm meeting, I'm changing the questions. ⁓ and I think for you, what I would ask is,

because of the work that you're doing and because of your own personal experience.

What do you hope, and I know that it's hard to picture these things in the climate of our country right now, but what do you hope to see change so that we can better support birthing people and families moving forward?

Kara Kushnir, LCSW (45:06)
Gosh, well, if I could have like three wishes or like some magic, I could do a whole lot of things, right? Like there's so many things. I think that I would hope that we can shift from a culture of expectation and shame to a culture of acceptance and embrace. And I think...

Chelsea Myers (45:13)
Right, like me? Yeah.

Kara Kushnir, LCSW (45:35)
to the point of the village support because there is such expectation on what parenthood is supposed to be, how you do it well, how you get birth "right", how you're supposed to feel. And that's where the expectations are so high and unfair and incongruent. But if we can shift things towards how do we simply acknowledge where people are right now, knowing that there will always be, I think, unfortunately, some

some sort of system of oppression or some sort of system of difficulty that exists, something that happens that we could have the best intentions and it could go wrong and we can't control everything. But if we can shift where we move towards each other rather than when we move away from and sort of shield from each other or stigmatize things so that people get isolated and alone and it becomes much more about acknowledgement and support and validation in our communication relationships.

the way that we expect the other people to show up for the parent and rally around them or parents, I think that that would dramatically change the landscape. And to that point, I think that the biggest thing I would say too is that should not just be in birth and postpartum, it should be in pregnancy, it should be in trying to conceive, it should be in decision-making about pregnancy. There are so many nuanced layers to this. And when we support

families and the nuances that exist around what they look like and how they come to fruition, we will inherently create a culture and really a country, I think, that understands that families deserve better and we need to support them in whatever form they take without judgment and imposition of different experiences that may or may not apply. And that's not about us, it's about them. So

I think that would be my hope for the future. I think we have a lot of work to do. ⁓ But I don't think we should stop doing it. I don't think that we stop fighting. I don't think that we stop speaking. I don't think that we stop challenging. I think that we can do so while balancing that with taking care of ourselves so that we hopefully don't burn out. And that we can also do that while balancing just existing presently in our lives. Because when we show up with our loved ones and our kids and we're present with them, it is an act of

resistance against those expectations in the machine. It means we are not letting joy and love being taken from us because we are choosing to be present with love and connection with our kids and not let that be taken from us when we feel alone or isolated or that other things are being taken.

Chelsea Myers (48:15)
Yeah. Yeah, that encapsulates so much and is like, yes, it's what so many other countries have already figured out for centuries. And we, for some reason, have just not ⁓ jumped on that train. So yeah, we are going to keep fighting. And I'm thankful for people like you that take your experience and create something from like literally.

physically create something from it to put into the world so that others feel seen and validated because that is I think the greatest form of compassion is just seeing someone else. ⁓ Kara, I could talk to you forever, but I will honor your time and I thank you so much for the work that you're doing. I thank you for creating this amazing book.

and for sharing your story with me and my listeners and some tools and what helped you and what could help other people. the biggest message is just keep trying, keep trying. But yeah, thank you so much for joining me today.

Kara Kushnir, LCSW (49:30)
thank you for having me.