Transitions: Becoming Us – Part 2

Disclaimer: The following transcript has been autogenerated and may contain occasional errors or inaccuracies resulting from the automated transcription process.

Host (00:01):

Hi there. Welcome to Mental Health Professionals Network podcast series MPNs aim is to promote and celebrate interdisciplinary collaborative mental health care.

Dr Monica Moore (00:17):

Welcome to Ageing Well, a podcast where we’re going to be discussing our insights, some tips, and also what we as clinicians and as people have discovered about the challenge of bringing children into our lives and we hope that you’ll find this helpful. I’m Monica Moore. I’m a GP with a special interest in mental health and with me is my friend Julianne Whyte.

Ms Julianne Whyte (00:40):

And I’m a mental health social worker who loves to talk about and reflect and important issues in life and hopefully make a difference. Thanks Monica. So this is the second of our podcast in this particular topic, isn’t it?

Dr Monica Moore (00:55):

Yeah, that’s right. So we’ve talked about all the things that we’ve noticed and from our experience, and then we are going to share some ideas that we think some people might find helpful and also about our interactions as clinicians and the sorts of things that present and what we’ve noticed other clinicians our referral base can provide in terms of support and help for people when they bring children into their lives. And so I was thinking as a mental health social worker, we were talking about the cases that have really left an impression on our lives, and you were talking about how you deal with someone who is so distressed, like a mother who’s had a baby, who is so distressed that she’s not eating, she’s not sleeping. What we would as a GP would call a psychotic depression. And I really liked the way the sorts of things that you talked about, how you would handle it.

Ms Julianne Whyte (01:47):

Oh, thanks Monica. I call them really urgent referrals if I got a phone call and as we did, I was telling you a case the other day of this beautiful young mom that had, the doctor had rung and said that this had to be an urgent referral. And we’re in a small rural community, so access to psych units or mother baby units is quite limited within our local community. They’re available but not local in our community. And so we did take her urgently, so we got her to come over straight away. And luckily I did have some time to see her, but you could just see the panic and what my mind as a clinician went to straight away was what might be happening at her brain level. And I just knew that I had to try and hold her distress. She was absolutely distressed and from what I gathered from the GP was that there’s some trauma history or something there in the background that hadn’t been disclosed previously.

(02:38):

She hadn’t been anybody’s mental health client before, obviously for physical health needs but not mental health needs. And what we did with her was just allowed her a space to deescalate that stress. So using ourselves as in therapy, those lovely micro skills we use. So using tone, voice and tone, rhythm and volume of our voice, talking to her very gently and quietly, the receptionist, a beautiful receptionist and aberrant who just took the child for a while with permission of the mother. Of course, we didn’t steal the child, although we were tempted to. He was so beautiful. But then, so our receptionist held the baby for a bit while I just sat with the mother and gently spoke to her about where she was at and how her brain must be just so frozen. But what we actually got her involved with was a bit of reiki.

(03:24):

We are very blessed to have some complimentary therapies in our clinic and she was very, I don’t know, a bit cautious. We had her baby and it wasn’t about her, it was about the relationship and her coping and her mothering, and she obviously felt so overwhelmed, but I explained to her that just allowing that brain to just go to unload, to just get it off autopilot, to take it down a couple of levels and just let her think quietly just lower. So clinically I was thinking I’ve got to drop that adrenaline and cortisol level down so that she can actually start problem solving and thinking and the difference. When she came out of her reiki session, Monica was absolutely amazing. Luckily her baby was really settled. He was quite calm with our staff. She came out of about a 20 minute reiki session just in this totally different state, not able to problem solve yet, but the panic and the despair and the distress had actually just shifted a notch from being perhaps where she would’ve been at perhaps 80 or a 90 on a, I were talking the other day about subjective units of distress.

(04:26):

If you’re talking about her SUD scale of one highly, highly distressed to perhaps less distressed, she’d gone from perhaps an 80 down to a 60. And you could just see the capacity now to talk to her a bit more about how is she problem solving, what was happening for her? What was the key thing that was causing the distress? Sometimes it’s not the talking therapies that are always needed. Sometimes it’s that validation, those micro skills, the alternative complimentary therapies, a bit of reiki or meditation just to actually do as a clinical intervention to lower those stress responses in the brain and the body. How would you know to refer someone to what counsellor? Like counseling, like a good pair of slippers and you’ve got to get the right pair of slippers.

Dr Monica Moore (05:12):

You have to have the good fit. Yeah, yeah. No, you don’t know sometimes and sometimes you refer someone and they come back and they go, no, that wasn’t a good fit. So you always have to preempt that, explain to them that that’s going to what you’re trying to do. But I was thinking that that sort of wideness of referral, one of the things that I know from my training as a GP is that the physical touch of the GP can be very healing. And I never quite understood why until I realised that as babies, our development is severely curtailed if we don’t get touch and how important touch is in feeling safe and in brain development. And so Bessel van der Kolk and his research recommends regularly that people have as part of trauma therapy, not just whatever flavour of talking therapy the therapist is doing, but also physical therapies like massage.

(06:09):

And I think you’ve illustrated that really well with that case. But it’s that thing about our trauma is embodied in our bodies. We experience our distress in our bodies. And so one of the ways of decreasing that distress is through the body. And I think when you and I were talking about this situations where someone’s really distressed, they’re not sleeping, they’re not eating, and that I can remember years ago that the only option was really to admit the mother to a psychiatric unit with or without the baby. There weren’t many units where the baby would be there and then suddenly that baby would be instantly weaned and onto formula. And it was distressing, so distressing for everyone concerned. And so we are very lucky in our area now to have a perinatal clinician and she would be someone who does house calls, sorry, she does house calls. And she would be someone that I would highly recommend because she’s exactly that appropriate fit for someone in that situation. And there are some times where people do need that support of being in a therapeutic environment like an admission. And I mean I work in Sydney and so that’s available, but not always.

Ms Julianne Whyte (07:23):

But we have even in a rural community though, Monica, it’s lovely. We’ve got Tresillians which is a wonderful organisation that do fantastic support and a bit like we were talking about what resources we have readily on available and we actually have a resource that can quickly go to that we’ve put together around the referrals. This is an urgent. This is not something you put off and go look that can wait three weeks. This is urgent because a mother and her child or a father and the child, if they’ve got this stress response, it is as critical. I see it as a level one triage that this needs to be responded to today immediately because the risk of harm to the baby or the risk of harm within that couple, even if say one of those parents doesn’t cope and then the tone of voice changes, there’s that frustration.

(08:11):

Irritability, the potential for using alternative means to self-soothe like drugs or alcohol or for physical or verbal attack or just even affecting the relationship is too great to put this as something that can just go on the normal referral, say, look, that can come next week. I personally feel these are having been there and in that moment experiencing this intense desire I not knowing what to do and thinking that I’m responsible for the life and happiness of this little person is critical. And I’ve actually been there at a point where I looked at my baby and I actually had to put him down in the cot and just walk away and think I was so tired, so frustrated, so overwhelmed, I didn’t know whether I could be trusted. And so I knew I had to put him down. He was safe, he was well, he was okay. And I went out to the lounge room and I rang my husband and my mother and said, I think I need help these people when they come to us. I could imagine, and maybe this is a bit of transference, countertransference, I’m not quite sure, but we’ve got to act now for these really parents that are in this particular state. Luckily it’s not everybody that actually go into a deep depression.

Dr Monica Moore (09:30):

And I think that experience of just feeling totally overwhelmed and putting the baby down and walking away and asking for help, I mean I had that too. It’s one of those things that it’s much commoner than what we realise, but it’s that if you don’t have a husband and a mother who can come and help you out, sometimes that adds to your distress. And as clinicians, we can support that person and normalise it and say, this is a normal human reaction to have to feel so overwhelmed. How can we help? It’s two people against the problem. It’s not a blaming, it’s not a shaming. It’s very much about doing that sort of multi-level listening and paying attention and asking questions and being curious. And I think that that thing about referrals and all those resources, I worked to create a whole sort of network of resources.

(10:24):

People that if people were having problems, their child wasn’t sleeping and they really were feeling overwhelmed and it was starting to affect their physical health, their mental health and how they were relating. They could have various clinics that would have either day programs or in house programs that they could go and stay. And recognising that we can have to differentiate between the normal sort of thing and what’s really ugly and what is urgent, and that’s what we as clinicians try and organise with our patients and clients and to recognise that sometimes we get it wrong. Please accept that your clinician is a human being too, and they may not actually get the severity of the problem, so let them know. I’m also thinking that’s kind of like post the event. I’m a lot into prevention being a GP, and I want to get a little bit from the dark side into the slightly lighter side. And I was wondering what kind of things do you, do you do any preventive work? What sort of resources, I mean with your own kids and great grandkids, what sort of resources do you suggest to them that they know about? There’s so much out there now.

Ms Julianne Whyte (11:40):

What I’m doing with a lot of my couples that are coming in a variety of ages, and it’s interesting that over the 16 or 18 years that I’ve been doing mental health work with, I’ve noticed a lot of my parents that are coming, first time parents are coming in a little bit older. And I’ve been talking a lot about the love languages, five love languages that we actually have because this is a major transitional part of our lives that perhaps the way we want to show and receive love changes or we miss the mark a bit because we’re so focused on this becoming a parent from being an individual. So if it’s the first child from being an individual adult to now becoming a parent, so even the title, we have changes. We go from being Julianne to mum and we go from being adults and a couple to being parents. So not only do we change in our roles, we actually change in the titles that we have. So, so much changes. So sometimes then are our schemas, our expectations of going from Julianne to mum.

Dr Monica Moore (12:40):

It’s our identity, isn’t it? That changes. Yeah, yeah. It’s our identity that changes. Yeah, absolutely. Which is highly anxiety provoking in a way.

Ms Julianne Whyte (12:49):

Absolutely. And I remember as much as I absolutely love my mother and if she’s listening now, I hope she knows I love her dearly, but I didn’t want to be my mother when I had my children. I didn’t want a mother like my mother, and I hear my daughters and my son saying the same, oh, I don’t want to be like my mother. And although you sound like your mother, and it’s the worst thing my husband can ever say to me is you just sound like your mother. And I think, no, I’ve tried really hard not to be in the things that I wanted to be different. And I’m not saying this as an offence to my mother, but my mother, mother to her way based on her experiences and her life’s journey and her expectations of having children and babies, I was her only daughter and I’ve got five brothers then.

(13:33):

So I thought now that when I’m a mother, I want to do it differently. It was very different to being how I wanted to be Julianne, the adult, to being Julianne the mother, and I wanted to put my mark on my mothering, but I actually didn’t know how to be Julianne the mother. And then I’d do things and I’d feel like, oh, I didn’t want to do it that way. That’s not how I want to mother. That’s not how I want to parent. And that’s not how I wanted to couple to do the relationship thing with David. I wanted to do it differently. And I’m finding that too with a lot of my couples that are coming in. And one thing I wanted to say too, Monica, is often when we, there’s this thing about a conflict of interest in our clinical practice so that if you’ve got a couple, a male and a female that have dealing with issues of parenting, often you’ll have one clinician seeing one adult and another clinician seeing the other adult.

(14:24):

And my experience has been that if we don’t actually at some point get them together, they may actually be given totally different advice because they’re actually going to tell the clinician what their version of the event might be and their perception and their problems, depending on the clinician’s perception of it, based on their experiences, they’ll be giving advice. So we might actually be pushing couples in different directions if we don’t actually ever get an opportunity to either as clinicians collaborate or to see them together. I don’t know. That’s a tricky space. How do you negotiate that space?

Dr Monica Moore (15:00):

Yeah, and this is why I was asking you about the sorts of things that you talk to parents before they have the baby or even to people who are pregnant. And as a GP, I get this sorts of advice that I give, what I prioritise because there’s so much information. And so I’ve now been prioritising communication skills because if the couple can communicate, if they can actually nut out and solve their problems, if they can use their love languages, which I agree with you, knowing your own love language and knowing your partner’s love language is just gold. It’s brilliant. And if they can communicate and problem solve, then they can deal with all those issues the best way possible of fatigue and finances and issues around intimacy and touch overload that the mother has where she just doesn’t want anyone to touch her because she’s already been touched and breastfeeding and all that kind of thing throughout the day.

(16:00):

And even those even more serious issues where there’s been birth trauma or where there’s been a pregnancy loss and the grief that goes on if couples know how to communicate. And so I’ve been recommending a book called How to Talk so Kids will Listen and Listen, so Kids Will Talk, which is actually about parenting, but it’s one of the simplest, most clear cut guidelines to good communication that I’ve seen in a long time in problem solving and the Wonder Weeks website now all these resources that I’m going to be talking about, but also about breastfeeding so that you know about breastfeeding beforehand, before you actually have to do the thing. And then normalising brain development and brain crying and waking through tonight. So those are sort of the things that I talk to people would talk to people about because they were all focused on the birth, of course, coming to the GP and Oh, I’ve got a placenta previa and what does that mean? And all that. And I tried to kind of sneak in these things. Yes, but then you have a baby. So what are the sorts of things that you, sorts of ways that you prepare

Ms Julianne Whyte (17:06):

Monica, that’s the best thing you’ve said? Well, you’ve said a lot of really wonderful things that we are so prepared for the birth. We have a birth story, we have a birth, we are prepared for the birth, and husbands come in and we know how to do all that stuff really well. And when my daughter had her baby recently, her husband was, all of them have had beautiful caring partners in their births. Just been beautiful. And I’ve got to tell you, my husband wasn’t on one of them. Can I tell you something? A story about one of my babies? Oh my God, I was in there. It was round number six. So David sort of thought he’d been there, done that, and he was sitting in the room. So I’d been induced, I had to have about six inductions out of the eight. It was a bit revolting and they were all different.

(17:44):

Not one induction was the same. So there was a bit of, anyway, he was sitting there and it was a Sunday, bloody David, he was sitting on the chair at the end of the bed and I’d been induced. So contractions were starting to come on pretty hard and he looked up from the paper, said, how you going love? And I said, oh yeah, moving along. It won’t be long now. He goes, yeah, good. And they brought in lunch and I didn’t want lunch and it was a roast. And I’m like, no, no, no, I don’t want lunch things I think I’ll throw up if I have lunch. So he said, oh no, I’ll have it sitting there eating his roast, anyone going, oh god, it’s starting. And he said, okay, I’ll be there in a minute. He’s like, good on you. Anyway, that’s just a bit of an aside. But see, his expectations were been there, done that. Off you go and have the baby and I’ll come down in a minute. I’ve got the paper to read and I’m having lunch. It stays with you though, doesn’t it? And they’re the things that do come into your narrative, your life narratives. And I think what I talk to people about is these things.

Dr Monica Moore (18:38):

Isn’t it interesting that when you think about it, but you don’t think of birth trauma as like blood and guts and either you dying or the baby dying or any of those complications. You think traumatic for you is how alone you felt in that moment how you’re just a baby making mammal rather than a human being going through an experience and still needing support. David, what the heck are you doing?

Ms Julianne Whyte (19:01):

That’s exactly right. But then I’ve kept thinking, how blessed am I that he’s there? My mother didn’t have dad at any of our births and here am I complaining that he had his roast. But anyway, that’s funny.

Dr Monica Moore (19:14):

Yeah, but was he really there or was he doing the Crossword? I mean look, I think these things where what touches us and what has meaning to us when we go through our own experiences, we can look at what’s going when someone says to us, that was really traumatic when that happened to me. And I go, gee, I wouldn’t have and then I can remember, but we are all individuals, we all experienced our transitions are what happens to us differently. And isn’t it our role to recognise and have that multi-level listening that can actually help us to understand them and to help them feel understood. And I was thinking when you were talking about that, I was thinking about various situations where I didn’t feel quite understood. And I have lovely in-laws, they truly are delightful, but they parented differently. Their advice was different. And so I still remember a certain degree of tension between me and my mother-in-Law when my son was really little and he was doing so much crying about the advice that she would give and how she saw my parenting and she was just trying to be helpful.

(20:26):

But I think one of those things about accepting support and supporting and accepting help from family members is that thing that happens about the conflict that happens outside of the couple and how sometimes it can triangulate that you have a problem with the mother-in-law. And so instead of sorting it out with the mother-in-Law and using your communication skills, you actually try and get your husband to talk to his mother. And that’s triangulation and it never works. I can say that from my own experience and you know what I mean, it’s really terrible until you actually work it out for yourself. Either you decide not to say anything and just accept the love or you decide to say something and say, when you say that, it’s really not helpful for me. But I think all those emotions that we feel, unless we can have people around us like friends and family members, even if you’re lucky enough, the local clinic sister who supports you, people who can really listen and say, yeah, it is hard because we might read books, we might watch movies and they’re telling us a different thing altogether. Advertising for example tells us a different thing and even our friends might transition differently through their parenting. So we really need to have our tribe.

Ms Julianne Whyte (21:39):

Yeah, your tribe is so important. But I was just thinking as you were talking that one of the things I do with couples when they come in, if you’re just sort of doing that listening, thinking, yeah, I can hear that there’s some conflicts or some role confusion or something that might be happening in the transitional period, wherever that’ll be. Because I think every time the baby goes through a transition, your parenting goes through a bit of a transition as well as the child grows and develops. But I often go to that person or the couple and ask what were they like going through puberty? How did they deal with other life’s transitions to actually try and get them to do some here and now that foregrounding and backgrounding? So it was transitioning difficult for you. We went for high school. Do you remember, was it a bit tricky as you took on new roles?

(22:24):

Do you remember a time when perhaps this might’ve been or similar, when you changed jobs or roles, do you find transition difficult to try and get them to see that what’s happened to them is not just about having a baby and bringing a baby into the home, but it is about how we deal with change, how we deal with adjustment. And I think that sometimes regardless of the age, we can actually clinically just get them to reflect to say, well, this is not, I’ve done it before. I’ve done transition, might not have done parenting before, but I actually have coped with change before. And to change the focus of their thinking from it’s all about the baby and it’s all about me and it’s all about this urgency of getting it right to, I remember feeling like that when I was 16 or the year I went to uni or when I went away on exchange overseas. How did you do that transition? What worked?

Dr Monica Moore (23:13):

Well, I hear what you’re saying that we do use sort of similar skills. We have to use our creativity, but it’s really interesting because as I was sitting listening to you, I was hearing not just some of my patients in my head but my own head and I’m kind of going, but all those other times it was just about me. This time there’s a baby and it’s so terrifying. And I think that says something about me, about how terrified I was, even though I am a GP, when I got the feeling completely and totally responsible and I would behave in some ways and my husband would say, you would think that baby was an orphan and sorry, didn’t have a father, didn’t have anyone else. The way you talk about something happens to you that the baby will have no one. He’s got me. And I would deliberately sort of have to remind myself, yes, he’s got someone, okay, if I don’t get it right, there are other people around.

Ms Julianne Whyte (24:09):

And that’s a really good point. I often say to mothers and to fathers that we both, because we’re male and female and male and females are different regardless of what we think, we aren’t different. We genetically, our DNA is different. And so we parent different and it’s not wrong, it’s just different. So the male might do certain parenting things and I’m not going to use the gender thing. They do the rough and tumble play, some do some don’t. Some do the creative stuff and whatever. So however we parent, parent according to our beliefs, our schemas, the way we interact with this child and I think is that other parent reflecting on how the other one does. So just using an example, so if I watched my David, David’s a very outdoorsy, he’s sort of saw his role with the children perhaps when they were little.

(25:02):

He was wonderful when they were little, he was the guy, I gave all the kids and he’d have a shower with four boys. How delightful. I’ve got these beautiful photos of naked men in my shower, here’s David and all the different, if you could see my hands, I’m doing the descending heights. But David would take all the children and shower them all and he would love that. It’d be rough and tumble, absolute pigsty of a mess in the bathroom. But they talk about showering with dad and bathing with dad and the bubbles and the fish and they’d be fishing and they’d be talking about stuff and they were having a lot of fun, probably doing an awful lot of other boy things as well. But he did it David’s way. Now when I bathed them, it was very different. It was calmer, it was soft, it was gentle. There was a bit of massage involved, there was smooth stuff. I actually put music on. And so we did it differently. It didn’t make it right. I remember for a while thinking, bloody hell David, don’t stir ’em up, they’re about to go to bed, shit. And I’d get cross with him and then I thought, oh no, actually this is David’s way. David’s interaction his way. I have to step back and go, okay, you parent, this is your time to parent, not my time to criticise.

Dr Monica Moore (26:05):

And it’s interesting that thing about appreciating, it’s about appreciating the gifts that our partners bring and other people bring. And when I’m thinking about how empowering it is to be appreciated, to have your gift recognised, my father-in-law would play with my son. It’s all about trains. And my son would so love going and playing with grandpa, that’d be great, and my husband many things, but just how gentle and kind he was and how he could just stay really calm in situations where I’d have go, I’m just going to have to go for a little bit of a walk outside and then I’ll come back in. But he would stay really gentle and calm. So it’s all that sometimes we have to deliberately sit down and go, what am I appreciating about my partner at the moment? Because at the moment I’m only noticing the things that are going wrong.

(27:00):

And we do have to deliberately do that. Now I do psychotherapy full time. The more I do that, the more I recognise how important it is to know ourselves, to actually understand where our stuff comes from, our tendencies, our quirks, our not so good, best aspects of ourselves so that we don’t expect other people to be perfect either. We don’t expect ourselves to be perfect, but we can work on our own stuff. We can do, we haven’t talked about it, but how important self-care is for parents. And as a GP I would say, I’m going to write a script for you and that you actually have to lie down for 10 minutes when the baby lies down. That’s a script that goes on the fridge. If you don’t lie down for 10 minutes when the baby lies down, you’re not actually taking your medicine. And it’s not just for you, it’s for the baby. And the importance of self-care of all the things that you, we are not going to cover here, but how the priority for that you think, oh no, I have to just be with the children. Not so, because if you’re not doing your own self-care, you’re not emotionally available for the children and that’s actually not good for anyone. And so how important it’s to prioritise sleep.

Ms Julianne Whyte (28:12):

That’s a really good point, Monica too. I think some people just need a bit of permission to say, look, you know what the doctor said, the social worker said, or my clinician said I have to do. And sometimes it’s saying to the other person, if it’s the male or the female, that I actually have to do this. I think we’ve got to be too a bit mindful here in our chats that might first anyone listening that it might be very female orientated. I think there’s a lot of depression in dads and males or a feeling of misunderstood and having permission to rest as well. I know my son-in-laws actually get up and do night feeds. And my David never did it, but he said, why should I get up? You’re the one breastfeeding, one of us has got sleep, so he never got up. And my son-in-laws and my sons get up and do night feeds as much as they can.

(28:58):

So they’re sleep deprived as well. And I think we’ve got to give the dads as much as we give the mothers permission to rest when the baby rests, but also to give dad’s permission to say, well look, you can ask your partner for this. Or even in same sex couples, regardless of the gender makeup or who does what parenting or who does the key and whatever, I think permission giving and we have that role. I think if people are saying, I don’t know what to do, we can actually quite take a firm stance and say, what I think you might need to do is have permission. You have permission because this is crucial for this reason. The mental health or the psychological development or your stress definitely affects the child. So therefore this is critical for you. And also it says something to the other person in the relationship about taking time

Dr Monica Moore (29:47):

And it says something to the children as the children are growing up where they see their parents looking after all the adults around them looking after themselves really well so that they can be their best version of themselves and they see their parents communicating their needs and negotiating their needs and finding out what’s going to work for the whole family. And it’s all of that kind of stuff that what are we trying to teach our kids here? Do we want to teach them that they can feel our resentment or do a parent who is available and who takes time out for themselves in order to benefit the whole family? I think that that’s really important and that’s why knowing yourself better in whatever way possible and sometimes having your own counselling can give you that insight and that permission. And I think that that’s where personal counselling can be really helpful that you have that permission for yourself to do this and you can actually see the whole benefit for everyone.

Ms Julianne Whyte (30:45):

Before we finish, I’d like to, I just think one important thing, Monica, is as clinicians, so you as a referring GP, it is about the referral now under Medicare. So we get down to the technical. Under Medicare, someone might have to have a diagnosis of a mental illness. So a lot of people are loathed to go to the doctor and then a lot of doctors might say, well, this is a normal reaction to a life event. It is not a mental illness. You don’t meet a diagnostic criteria, your subclinical, no, I’m not doing a referral for counselling. You don’t meet the threshold. And we were talking the other day about how that would actually be perceived and we were talking about adjustment, just difficulties with adjustment or difficulties with stress that we don’t have to have a diagnosis of paranoid or psychotic depression. We don’t have to have a diagnosis of a severe mental illness to be referred for some additional support and counselling. Can I ask you how you feel about that from a referring clinician?

Dr Monica Moore (31:48):

I’m surprised that someone will say you don’t meet the criteria because in fact the DSM five has a criteria that says adjustment disorder and you have adjustment disorder with anxiety and adjustment disorder with depression. But adjustment disorder is a criteria.

Ms Julianne Whyte (32:06):

And you made a good point the other day about anxiety. You know how you talked about anxiety, the other anxiousness versus an anxiety. Do you want to go into that a bit? I thought that was just brilliant.

Dr Monica Moore (32:15):

So the thing is, whenever we are in a situation where we are either scared or we are angry or we are excited about something, okay, we are going to produce adrenaline. And so in the moment we are going to feel it as anxiety, especially if we’re not really clear why we are feeling that way. I mean there are some people who they’re not really good at recognising their own emotional landscape, so they’ll just feel it like there’s a lot of adrenaline floating around in my body. And that’s anxiety. That’s feeling anxiety and anxiousness. But anxiety disorder is where you have lots and lots of adrenaline and you dunno why and you don’t know how to manage it. And then that becomes a problem in itself where you get scared and angry at yourself for having the adrenaline in the first place. And so that’s really what I define as an anxiety disorder.

(33:08):

And there are lots of things that sort of go with that in that diagnostic umbrella. But what I’m saying is, is that feeling anxious is a normal part of life and having adrenaline in your body is a normal part of life is a survival thing. But I think that you can sort of say adjustment disorder. In fact, that’s why we were so interested in this topic of all the changes that occur in our lives and the sorts of challenges that occur at that particular time that are common to that situation, but also the things that we’ve learned through our lives and our clinical time that are helpful because transitions and adjustment is actually being human. We are doing it all the time. Yes. When we refer if, and the reason why we’re talking about Medicare is because if you go and see the GP and say, this is what’s happening in my life and I would like to see a mental health clinician in order to get some money back from Medicare or for the clinician to be paid, if they bulk billed, then you would have to have an item number diagnosis and that would mean that you’d have to have some sort of diagnosis like that. An adjustment disorder is one, you can use it.

Ms Julianne Whyte (34:15):

Absolutely. Yeah. No, I think that was important to say because as I was saying to you about some of my referrals have come, the perinatal anxiety, and as I said to you, it is an anxious period. It is a time of great transition and adjustment. So we would actually, and anxiety is a fairly normal state. If we weren’t anxious, we wouldn’t have survived as a species. So I think it’s about sometimes normalising and sitting with anxiousness and saying, I am feeling anxious. This is actually okay. Rather than slipping down into the shame of I am bad, I’m bad, I shouldn’t be anxious, I should be calm, cool and collected. I just think that’s unrealistic. I shouldn’t be anxious about anything, but it’s quite a natural feeling, as you said in the body.

Dr Monica Moore (34:57):

It’s huge stressful. You get this new job, it’s 24 7, 7 days a week and you get no training. Who would do that? Can I say though? I’m so glad I did. I’m so glad I did at times.

Ms Julianne Whyte (35:13):

Absolutely. So pleased.

Dr Monica Moore (35:15):

That’s right. It’s what they say about transitions, their growth

Ms Julianne Whyte (35:18):

And isn’t it interesting, the series is called Ageing Well, and I think when we talked about this before, we tend to think ageing well, we’re talking at the end of older age, whereas ageing well is this period of time, regardless of the age we’re becoming new parents, welcoming children into our home, then it is part of ageing. It is part of that growth and change that happens through life.

Dr Monica Moore (35:41):

And we were thinking, we don’t want people to think we’re just going to talk about getting old. So that’s why we decided, that’s why we decided we just love talking about change and how change affects us as human beings. And so we’re going to start calling our sessions transitions, and that’s going to free us up to explore all the ways that we react to change throughout our lives. And so I really hope that you can listen to us, to Julian and I continuing our conversations, both professional and personal, discussing changes through life, our transitions. And I really look forward to sharing this journey with you.

Ms Julianne Whyte (36:16):

Absolutely. And I’m with you too. I’ve got a great idea for the next podcast too, Monica, so I can’t wait. It’s going to be wonderful. Oh,

Dr Monica Moore (36:24):

Sounds good. Okay. It’s goodbye for me, Monica Moore, a GP with a special interest in mental health

Ms Julianne Whyte (36:29):

And goodbye for me, Julianne Whyte. I’m a mental health social worker. Goodbye for now.

Host (36:35):

Visit mhpn.org.au to find out more about our online professional program, including podcasts, webinars, as well as our face-to-face interdisciplinary mental health networks across Australia.