PERINATAL & POSTPARTUM THERAPY
Everyone told you this would be the happiest time of your life. It isn’t, and there is no one you feel safe saying that to.
Perinatal mood and anxiety disorders — PMADs — are the most common complication of pregnancy and childbirth. They affect roughly one in five mothers. They are also, of everything we treat, among the most treatable. What they are not is a character flaw, evidence that you weren’t cut out for this, or something you have to earn your way out of by trying harder.
You can love your baby completely and still want your life back. Both of those are true at once for a great many women, and neither one cancels the other.
What It Actually Looks Like
It is rarely the sadness people expect. More often it looks like:
- Anxiety that won’t switch off — a racing mind at night even when the baby is finally asleep
- Intrusive, unwanted thoughts about harm coming to the baby, which you have told no one
- Rage and irritability out of proportion to the moment, landing on the people closest to you
- Numbness, or a flatness where you expected to feel love
- Checking, googling, and re-checking, and never feeling reassured for long
- A conviction that everyone else finds this easy and that you are quietly failing
And it isn’t only postpartum. This work covers pregnancy, pregnancy loss and infertility, birth trauma, the NICU, weaning, and the particular disorientation of doing it all again with a second or third child.
Therapy Modalities We Use
There is no single protocol for this, because no two people arrive with the same thing. What we draw on most:
- Regulation and body-based work — because a nervous system running on four hours of broken sleep cannot be reasoned with, and has to be settled before anything else will hold
- Cognitive behavioral approaches — for the thought spirals, the checking, and the running commentary that tells you you’re doing it wrong
- EMDR — particularly for birth trauma, pregnancy loss, and medical experiences that your body has not filed away as over
- Practical postpartum planning — sleep, support, division of labor, and what actually has to be true for you to get through the next month
What to Expect in Therapy
The first session is not an interrogation. You will not be asked to prove how bad it is, and you will not be handed a worksheet.
Mostly we want to know what your days look like right now, what has changed, and what you are most afraid of. Bring the baby if that’s what makes the appointment possible — feed, rock, pace the room. Nobody here needs you to sit still.
We are not prescribers. If medication looks like it belongs in the picture, we will say so plainly and help you get in front of a reproductive psychiatrist who knows the pregnancy and breastfeeding data properly. Plenty of people do this with therapy alone; plenty do it with both. Neither route is the one where you gave up.
Your Village: Local Perinatal Resources
Pregnancy and the first year need more than one person, and therapy is only part of it. We keep a running list of the obstetricians, midwives, perinatal psychiatrists, pelvic floor therapists, lactation consultants, chiropractors, doulas, and new-mother groups we send our own clients to across Katy and greater Houston — with phone numbers, and a printable version you can keep on the fridge.
Who You Would Work With
TAYLOR GARCIA, MA, LPC
My experience in and out of the counseling office has lead me to find success in working with children, adolescents, parents, and women of all ages. My areas of interest include ADHD, anxiety, boundaries, family of origin issues, life transitions (specifically the transition into motherhood) and parenting. I approach counseling with the whole person in mind; treating mind, body, and spirit. I find it a great honor to be let into other people’s stories and witness their achievement in finding freedom and meaning in their lives.
I graduated with a Bachelors degree in Psychology from Texas A&M University and then received my Masters in Clinical Mental Health Counseling from Denver Seminary in Littleton, Colorado. Post graduation I have worked with clients of all backgrounds but especially enjoy those wanting to incorporate their Christian faith into the counseling process. I am fully trained in EMDR to help clients process trauma and am working towards my Perinatal Mental Health Certificate (PMHC) through Postpartum Support International.
“You can’t go back and change the beginning but you can start where you are and change the ending.”
– C.S. Lewis
The hope imbedded in the above quote is what I believe is at the heart of the therapeutic process.
Many of us have experienced loss, unmet needs or trauma in our childhood and while we can’t go back and change those things we can find agency today to be the person, partner, woman, or mother we want to be. I believe that the relationship between counselor and client is vital to the changes that clients make in their lives; therefore, I strive to create a warm, empathic, and honest working relationship.
MARISA COCKRELL, MA, LPC - FOUNDER
I am passionate about working with individuals and couples, teens and adults who find themselves struggling with anxiety, depression, grief, and their sexuality or gender. I work to create an environment of connection and care, without judgement, where clients can come to a better understanding of themselves and how they relate to others. I believe the therapist and client work together as a team to find and process ways to better cope with the pain in one’s life.
I hold a Masters in Biblical Counseling from Dallas Theological Seminary. I am EMDR (Eye Movement Desensitization and Reprocessing) trained. I am certified as a facilitator with Prepare and Enrich and I am certified in Restoration Therapy, Level 1. I also have extensive training under Dr. Mark Yarhouse in navigating sexual and gender identity for people of faith and training in Narrative theory work with Dan Allender.
Together, we will explore and address current concerns, as well as work to discover how the coping skills client’s have developed since childhood are causing stumbling blocks for them today.
MELISSA RENEAU, MA, LPC ASSOCIATE
SUPERVISED BY MICHELE BACHMAN, MA, LPC-S
SUPERVISED BY MICHELE BACHMAN, MA, LPC-S
I enjoy working with individuals, couples, and teens who are experiencing transitions in their lives. I also work with individuals who are struggling with anxiety or depression. I have experience helping couples and individuals transition to parenthood. I work to create a nonjudgmental space where clients feel safe and supported so they can explore their lives. Together we can explore your current concerns and help you explore your next steps.
I am an LPC-Associate under the supervision of Michele Bachman, MA, LPC-S. I earned a Master of Arts in Clinical Mental Health Counseling from Liberty University. I am trained in EMDR, Eye Movement Desensitization and Reprocessing. I have completed the Emotionally Focused Couples Therapy (EFT) Externship. I am also certified as a facilitator with Prepare and Enrich.
Taylor holds the specialist training in perinatal mental health, so she is usually who we suggest first. Marisa and Melissa also see pregnant and postpartum clients — so there is more than one door in. If a schedule does not fit or a person does not feel right, say so and we will help you land in the right place.
FREQUENTLY ASKED QUESTIONS ABOUT PERINATAL MENTAL HEALTH
IS THIS JUST POSTPARTUM DEPRESSION?
No. Depression is one of several perinatal mood and anxiety disorders, and it isn’t the most common presentation we see. Perinatal anxiety, perinatal OCD, birth-related PTSD, and rage are all part of the same family, and many women arrive convinced they don’t qualify for help because they aren’t sad. Anxiety that won’t stop, intrusive thoughts, and anger are just as much a reason to come in.
I’M HAVING FRIGHTENING THOUGHTS ABOUT MY BABY. DOES THAT MEAN SOMETHING IS WRONG WITH ME?
Intrusive thoughts are one of the most common symptoms of perinatal anxiety and OCD, and one of the least spoken about. They arrive uninvited, they are horrifying, and they are usually about harm coming to the baby. Most women say nothing, because they are terrified of what admitting it might set in motion.
Here is what is clinically true: these thoughts distress you precisely because they run against everything you want. That distress is the defining feature. Intrusive thoughts of this kind are not associated with an increased likelihood of acting on them, and they respond well to treatment.
Postpartum psychosis is a different and much rarer condition. It involves losing contact with reality, and it is a medical emergency. If you are seeing or hearing things others don’t, or the thoughts feel like instructions rather than intrusions, call 911 or go to an emergency room. You can also reach the National Maternal Mental Health Hotline free at 1-833-852-6262, or call or text 988.
Short of that: saying it out loud to someone is where it starts getting better. You will not shock us.
CAN I START THERAPY WHILE I’M STILL PREGNANT?
Yes, and it is often the best time. If you have a history of depression or anxiety, or a previous difficult postpartum, you are at higher risk of a PMAD this time — and building the support before the baby arrives is far easier than assembling it at three weeks postpartum on no sleep. We can put a postpartum plan together with you while you still have the capacity to think.
DO I NEED MEDICATION?
Maybe, maybe not. We are therapists, not prescribers, so this isn’t our call to make — but we will tell you honestly if we think it’s worth a conversation, and we can point you to psychiatrists who specialize in pregnancy and breastfeeding and know that literature properly. Many people do this with therapy alone. Many do both. Neither one is the version where you failed.
DOES THIS COVER PREGNANCY LOSS OR INFERTILITY?
Yes. Miscarriage, stillbirth, termination for medical reasons, failed cycles, and the long grinding uncertainty of infertility all sit inside perinatal mental health, and all of them tend to be grieved privately because other people don’t know what to say. You do not need to have a living baby for this to be your loss.
MY BIRTH WAS TRAUMATIC, BUT EVERYONE KEEPS SAYING I SHOULD JUST BE GRATEFUL.
A healthy baby is not a reason your body should have filed the experience as fine. Birth trauma is common and under-recognized, and “at least everyone’s okay” is one of the loneliest sentences a woman can be handed. If you are avoiding reminders, replaying it, dreading a future pregnancy, or flinching at medical appointments, that is worth treating — and it responds well to EMDR.
CAN MY PARTNER COME?
Yes, and sometimes it changes everything. Partners are often frightened and out of their depth, and they get PMADs too — fathers at meaningful rates that almost nobody screens for. A session or two together can turn “what is happening to her” into something you are both working on.
HOW SOON CAN I BE SEEN?
Reach out and we’ll tell you honestly what our availability looks like. If we can’t see you soon enough, we will say so and help you find someone who can. This is not a stage of life where being put on a long waiting list is harmless.