“As a physician, psychiatrist, and psychotherapist, my ultimate goal is to listen. To hear a patient’s story as they tell it in their own words and in their own time. To help them shape and understand their own narrative.”
What was your path to becoming a psychiatrist and psychotherapist?
In medical school, I first thought I would become an OB-Gyn, because I loved learning about pregnancy and delivery. But what I loved even more was hearing about the experiences of each patient and bearing witness to their journey in becoming parents. This naturally led me to psychiatry, where I have been so lucky to be part of a dedicated group of psychiatrists working together to create the medical specialty of reproductive mental health.
How has the field of women’s mental health and reproductive psychiatry evolved in recent years?
When I first began my career, the field of reproductive psychiatry that I was most exposed to was in research — I had little formal clinical exposure to this field, and there were virtually no formal training opportunities for psychiatrists. So initially I was one of a tiny handful of psychiatrists in New York focusing on this area. It was really a leap of faith and it involved a lot of breaking new ground. I spent the first part of my career as the Associate Director of the Women’s Program at Columbia, where I created and ran the consultative services for the department of OB-Gyn and oversaw all of the trainee educational initiatives in reproductive psychiatry. I am a now on the leadership team for the National Task Force for Women’s Reproductive Mental Health, which is creating the first standardized digital curriculum in reproductive psychiatry. The task force has now expanded to include over thirty institutions across the country. It’s thrilling to be part of an ever-expanding network around the country and the world that is building a field of knowledge from the ground up.
How does collaboration happen between providers and disciplines?
Women’s mental health is ideal for collaboration among disciplines. The women we work with are already frequently in contact with the medical system, from OBs to midwives to pediatricians — it’s interdisciplinary by nature. Also, the period of time from preconception through pregnancy and postpartum is a time when patients are really motivated to be well, and they are open to getting support from a variety of sources — from managing stress to optimizing nutrition to utilizing acupuncture. So this makes collaboration very easy and very fun!
What is your approach to working with new and expecting parents?
Working with patients as they become parents is a deeply rich area because it is a time of such immense transition. There are all of the concrete changes that someone goes through, throughout preconception, pregnancy, delivery and postpartum. But it’s also the change of each person within themselves and who they wish to be as a parent — which is often shaped by how they were parented. There can also be significant grief and trauma difficulties on the road to becoming a parent, including pregnancy loss, stillbirth, infertility, and other adverse outcomes. Last, becoming a parent is a lot about building attachment skills, which is an area that psychotherapy is well-suited to address. So in this work I try both to work both pragmatically about preparing patients for parenthood and also thematically, to help them give voice to their own goals and hopes.
What does a first session with you look like?
I think it’s really courageous to walk into the office of a mental health professional. It can be scary and overwhelming, and sometimes people are suffering a great deal by the time they are able to reach out for help. So during a first session, my goals are to try and alleviate the level of distress the person is in, to identify a workable plan for moving forward, and let them know that they don’t have to suffer alone. Getting a detailed history is really important from a diagnosis and treatment standpoint, so over time I do ask an enormous amount of questions. But in a first session, I aim to focus on working to create a practical plan that takes into account what each patient articulates is their most pressing issue. Ultimately, what I try to do is genuinely listen without judgment, and to hear each patient tell their story in the way that makes the most sense for them.
“Becoming a parent is one of the biggest transitions that a person goes through in their lives—physically, mentally, and emotionally. It’s a journey from the inside out.”