Prenatal Couples Therapy: Learning to Communicate with a Baby on the Way

I am a big believer in preventative measures when it comes to your physical and mental health. Many women plan and prep their bodies for a potential pregnancy through exercise, healthy eating, Ob/Gyn appointments, and taking prenatal vitamins… but how many prepare their minds and relationship for the transition into parenthood?

Prenatal therapy is a term I came up with to describe the importance of establishing healthy communication and mental health prior to a pregnancy or birth. Lots of focus is put on the mother during a pregnancy, but we often forget that although things are changing for mom-to-be they are also changing for the relationship.

Bringing a baby into the world means bringing another person into your family dynamic. For many relationships there is a drastic shift (whether it is baby number one or two or three) in the relationship as attention is split between more people. Partners have all sorts of feelings as well, when it comes to a pregnancy, and many times we forget that they are going through changes too.

One of the things I remember most about my own pregnancy with my first born, was how my husband voiced that he felt left out of so many things. While he was at work, I was at home putting a nursery together and going to doctor’s appointments, but it never crossed my mind that he wanted to participate in these things. We had a thorough & productive conversation (we’re both therapists so this isn’t uncommon for us) that led to a whole afternoon together building a crib and celebrating the new baby, and he began attending every doctor’s appointment (even though the doctor’s were surprised to see him…every time).

This is just an example of how communication is so important around this life transition. Once baby is here it is harder to find quiet time to have in-depth conversations, and communication often takes a turn for the worst. Attending prenatal couples therapy allows time to think about this shift as a team and discuss some major ideas that may not have been relevant up until this point.

Some of the topics often looked over prior to having a bun in the oven:

  • Will household duties be distributed differently (especially during postpartum recovery)? What will it look like once maternity/paternity leave is over?
  • Are visits with family welcome? Who is high on the “frequent flyer” list (grandparents, uncles/aunts/cousins, friends, etc.)?
  • What family/cultural traditions will be practiced? How about holidays/birthdays/vacations?
  • What parenting/discipline style do you expect to use? What was your experience like with your own parents?
  • How will you communicate your unique needs? Will you need “me time”?
  • What will “couple time” look like? Date nights? Childcare?
  • What are expectations around physical and emotional intimacy (especially during postpartum)?

This is just the tip of the iceberg. So many decisions will be first time decisions, and first time discussions. Thinking about these things in a space that provides extra tools and insight to communicate effectively can be a lifelong gift to your relationship. Consider adding prenatal couples counseling to your “get done before the due date” to do list. It may be the key to a smooth transition from two to three.

Journaling: Major Key to seeing Progress in Therapy

Major key alert! *in my DJ Khaled voice* Keeping a journal during your mental health journey can be a game changer! Therapy is a journey, so it is important to document your progress and make note of the tools you learn along the way. You are basically making your personal play book to mental health success.

Now daily journaling doesn’t have to be your thing to make a journal a useful tool in your mental health journey. Using a journal to document your goals initially as you start the therapy progress, and marking turning points periodically can still have benefits. I have seen clients of all kinds, those who loved writing and kept journals long before attending therapy, and those who bought a journal after a few therapy sessions because they wanted to write down the gems that they were forgetting between sessions. Both found it very useful.

It has been proven over and over that journaling creates intentional, introspection, which is a key part of the therapeutic process. Being able to not just articulate emotions, but being able to read back over how your emotions have evolved over time is an invaluable asset to your mental health journey. Bringing a journal into therapy can also allow for more intentionality when documenting homework assigned or questions posed by your therapist.

Keeping track of some of your basic needs in a journal, such as whether you got a decent nights rest or regular exercise, can also be important data for your therapist to collect and utilize to better identify your mental health needs. Remember that your physical and mental health are significantly intermingled.

Added bonus, journaling often facilitates the work that must be done in between sessions. The majority of therapeutic work is done outside the therapy room. Words, ideas, and insight is exchanged in a session, but ACTION takes place outside a session. Use a journal to write a new narrative of action, change, and progress. How has journaling played a role in your mental health journey?

Coming Together as One: Couples Counseling for Interracial Relationships

In 2015, 17% of all newlyweds in the U.S. were in an interracial marriage. This is representative of an increasing trend in interracial marriages over the past few decades. Personally, I am also in an interracial marriage, and have seen an increase in interracial couples coming into therapy.

In any marriage there can be differences in values, beliefs, or just lifestyles that can be difficult to decipher and learn to love. For interracial relationships these differences tend to be just a little more obvious. When working with couples from different backgrounds (whether it is different races, religions, or family dynamics) it is important to start with establishing the things that bring them together. What are the values you share and the customs you both enjoy? And more importantly, what really drew you to your partner?

Once this groundwork of togetherness is established, you can look at the things that may be barriers to intimacy or value clashes that result in ongoing arguments or miscommunication. It may sound silly, but many couples (interracial or not) don’t discuss some of their deepest values before tying the knot. This creates a plethora of stuff to sort through once they are married, leading to marriage feeling “difficult” or “unsatisfying”.

Some of the common themes couples forget to mention pre-wedding are:

  • how to incorporate different faith practices
  • dealing with family members’ biases
  • family traditions to continue, and whether it will differ if kids come into the picture
  • gender role expectations
  • differing parenting styles
  • values around money
  • managing comments from strangers
  • multi-family households

Now a lot of these are topics that any couple may need to look more deeply into, but for interracial couples more items from this list may have been forgotten or looked over. Having to deal with one stressor vs having to deal with 3 or 4 value clashes may be the difference between a lifelong romance and a trip to the attorney’s office.

Partaking in pre-marital counseling or pre-natal counseling, can be great ways to recognize the diversity in your relationship and establish a joint culture of love and respect for the various beliefs and practices in your relationship. Use the therapy process to increase the tools you can utilize to communicate effectively and understand your partner fully. Make this a stage of togetherness and development on your way to a happily ever after!

Do Not Suffer in Silence

Too many times people feel alone in their darkest times and never receive the support that they need. COVID-19 brought to light for many the importance of social interaction as a human being. I want you to know that you never have to be alone.

An important part of the therapy process is safety planning for those dark moments. A safety plan is not a guarantee of safety, but when practiced regularly and incorporated into day-to-day life, it can be an important way of minimizing harm. Safety plans often have 5 steps: Identifying triggers, using coping skills, reaching out to supportive friends/family, utilizing warmlines/crisis lines, and calling emergency services.

When you are able to identify the things that ignite dark thoughts or feelings, you are able to recognize what coping skills to utilize. Sometimes that isn’t enough though. I encourage those with a safety plan to really lean into those support persons. Notifying them when you originally make your safety plan with your therapist that you are identifying them as a support person. Talk to those individuals about how they may support you during a difficult moment. What can they do/say to help increase your safety. You could even supply them with a copy of your safety plan. Having a “safe word/phrase” so you can quickly and discretely notify them that you need assistance (the “notOK” app is a free application that can do this for you). This prepares both yourself and your loved ones for a crisis situation.

There are lots of ways to access mental health resources in a time of need…

Therapy Apps:

oscER San Diego


Ayana Therapy

It is also important to be aware of crisis resources in your community. Below I have provided a list of warmline/hotline numbers for various crises:

National Suicide Prevention Lifeline: 1-800-273-8255

National Domestic Violence Hotline: 1-800-799-7233

National Trans Lifeline: 1-877-565-8860

Crisis Text Line: Text “HOME” to 741741

California Warmline: 855-845-7415

Trevor Project (LGBTQ Youth Lifeline): 1-866- 488-7386 or Text “START” to 678678

National Child Abuse Hotline: 800-422-4453

If your crisis has elevated to an Emergency situation please contact 9-1-1 or head straight to your local Emergency Room.

How to Cope with Racism

Racism is the pandemic that has been plaguing Black people for 400 years. I really wish I didn’t have to write about this, but here I am talking about racism in America in 2020 (the whole year has been trash, so why am I even surprised).

I first want to say…I see you. I see the hurt, pain, anger, sadness, frustration, worry, and every other emotion engraved in your beautiful, melanin rich skin. This deep anxiety within us that at any moment someone could dehumanize us, insult us, degrade us or worst and no one will see it, infringes on our peace and joy daily. From microaggressions to killings in the street, we deal with a myriad of stressors everyday. But how do we cope?

I want to give you a tangible breakdown on ways to cope with racism in your life.

Lean In

Lean in to the uncomfortable conversations. Taking a stand for yourself and others can bring a sense of relief. It may be initially uncomfortable, but it often leads to a release of buried thoughts and emotions. Be honest with yourself and those around you about how you feel. Read about anti-racism, black history, or personal stories of resilience to bring light to the shared experience of dealing with racism in America. Use your voice to speak up for change. Join a protest, sign a petition, donate, write, post, vote, whatever helps you feel heard!

Reach Out

Touch base with your support people. Those who you know will support you and make you feel good. Whether that be a best friend, a coworker, your therapist, or an acquaintance who is sharing in your experience. Speak about your hurt and let out your emotions. If you are unable to speak with close, loved ones try to journal or pray about your grief. Recognize the layers of emotions and let them out.

Shut Down

This may be the most important one of all. Shut down and recharge, so you can show up as your best self in your relationships and life. Take a break from social media or the news. Take some time off from work, so you don’t have to mask the emotions to maintain professionalism. Give yourself the basic fuel your body needs, whether that be some yoga stretches to recenter in the morning, eating a healthy meal to sustain yourself throughout the day, or making yourself a bedtime routine to ensure a good nights rest.

Know that we are in this together. Please take care of yourselves during these difficult times. And use the following resources to access help when needed:

California Warmline: 1-855-845-7415

San Diego Access & Crisis Line: 1-888-724-7240

U.S. Crisis Text Line: Text “TRIBE” to 741741

U.S. Suicide Prevention Hotline: 1-800-273-8255