Pregnancy and Postpartum

The perinatal period reorganizes everything at once: your body, your nervous system, your relationships, your identity, and your sense of control.

Many clients describe functioning externally while feeling internally unrecognizable to themselves. You are doing what needs to be done, socializing, working, managing, but you feel "off."

Or you may feel caught in constant self-monitoring, trying to do everything "right," diligently following advice, adjusting, optimizing, and still questioning whether you are doing it correctly or missing something important.

Or you may have thoughts you "shouldn't" have, or notice the absence of feelings you expected. You may find yourself holding multiple, often contradictory emotions at once: loving your baby and feeling overwhelmed, feeling bonded and also trapped or depleted, feeling grateful while grieving parts of your old life.

For many people, this phase also collides with long-held expectations about what pregnancy or early motherhood would feel like. None of these, on their own, are signs that something is wrong. They are what it looks like when identity, physiology, and responsibility all shift at once. What is worth paying attention to is when any of it stops moving: when the anxiety, flatness, or thoughts persist, intensify, or begin narrowing what you are able to do.

What I work with

Perinatal anxiety and panic. Worry that has outgrown its usual size, physical symptoms that arrive without warning, or a constant low hum of vigilance that does not switch off when the baby sleeps.

Postpartum and perinatal depression. Low mood, flatness, or the absence of feelings you expected to have. This can start in pregnancy, not only after birth.

Intrusive thoughts and perinatal OCD. Unwanted images or thoughts about harm coming to your baby, often paired with checking, avoidance, or a private conviction that having the thought means something about you. It does not, though the thoughts themselves can still feel deeply distressing.

Birth trauma. A birth that keeps returning, in flashbacks, avoidance, or a body that reacts before you have decided to. This includes births that were medically uncomplicated and births other people have told you were fine.

Pregnancy after loss or infertility. Attaching to a pregnancy while braced for it to be taken, and the way earlier loss can surface at each new milestone.

Rage and irritability. Often the least discussed and the most alarming to the person experiencing it.

Identity and relationship shifts. Who you were, who you are now, and the renegotiation happening with your partner in the middle of it.

This period can also bring earlier experiences into focus, including your own childhood. Fertility history may resurface during pregnancy. Birth experiences can shape recovery. Long-standing relational patterns often become more visible under the strain of this transition.

How therapy helps

My work is to help you understand what is actually happening in this phase, separate what is yours from what has been imposed or assumed, and identify what can be shifted versus what needs to be met differently.

In sessions, we work actively and collaboratively. We look at what is stuck and why, whether that is anxiety spiraling, nervous system overwhelm, relationship strain, identity disruption, or the collapse of strategies that used to work.

I draw on EMDR for trauma processing, CBT for unhelpful thought patterns, DBT skills for emotional regulation, and psychoeducation to make sense of what is happening and reduce shame.

Over time, the goal is not just symptom relief. It is that you see your situation more clearly, blame yourself less, and recognize that your capacity and constraints have genuinely shifted, so you can stop measuring yourself against your pre-pregnancy self and respond to what is actually true now.

How we can work together

I offer individual therapy, couples sessions when they make sense, and in-home sessions for newly postpartum families in San Francisco and parts of Marin.

Therapy is flexible and responsive to your circumstances: in person, virtually anywhere in California, walk-and-talk, or in your home. I also offer a generous cancellation policy for postpartum families. As your capacity changes, the structure of therapy changes with it.