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Dr Tanya Cotler| Psychologist

@drcotler

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Holding Moms and Children in mind
Together we repair wounds, and find wholeness in the hard
Writer/Speaker/Therapist
Columnist @psych_today
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I have stayed profoundly quiet around the Lindsay Clancy case , but there is one piece that has haunted me most—the idea that “she appeared well” as a measure of whether she could have been profoundly mentally ill.

As a maternal mental health psychologist who has worked over 25 years across many levels of the mental health system- in psychiatric emergency and inpatient settings, as well as cofounder of my own trauma clinic-I have witnessed over and over again that mental health and illness is complex. It requires high levels of training and expertise. Differential diagnosis - determining what is afflicting an individual- needs to be constantly re evaluated, (particularly when involving medication). And very little of the final diagnostic impression or the care the mother needs, should be based on how she presents especially to the public.

Some of the people I have seen who were most unwell were still smiling. Still functioning. Still showing up. Still trying to be the person everyone expected them to be. Particularly if discussing postpartum psychosis which affects 1/1000 women and is a psychiatric emergency that presents as a break from reality and can occur with intervals so that a mother can appear differently within hours of the day,

In a situation of psychosis, mania with psychotic or depression with psychotic features, the person can be the last to understand what is happening to them.

we cannot use appearance as evidence

Clinical assessment requires something different: listening carefully, looking for changes and patterns, asking differentiating questions, asking again, and most importantly patience, compassion, and noticing what may not be captured by words alone.

We have to create enough safety for mothers to tell the truth, and we need clinicians skilled enough to hear what isn’t being said.

We need a global humanity that begins to respect motherhood, destigmatize mental health and above all else we need systems of care that prioritize understanding maternal mental health, the mothers changing brain and prioritizes her wellbeing for it is inextricably linked to her childs. by @drcotler

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2 months ago

They may sound like simple phrases, but they carry meaning.

Our children are constantly making meaning from what we say — and from what we don’t say. Without us even noticing, they are quietly stringing together a story about who they are in this world, how they are seen, what their needs mean, and the impact they have in relationships.
So when we can, we want to choose our words with care.

Because children don’t just need limits or encouragement in isolation — they need both, held together.

They need to feel that someone is in charge of their safety:

“It’s my job to keep you safe. So no, you can’t go there or do that — but let’s find a way that works.”

They need to feel believed in, especially in the places they feel most unsure:

“I know you’re worried. I know this is hard. I believe in you — and in your ability to grow into this.”

They need room for readiness, not just pressure for performance:

“When you’re ready…” (For the Lego. For the math. For the next step.)

They need guidance in how to move through the social world:

That kindness is strength.
That speaking up is allowed.
That getting help is not tattling — it’s protection.
They need permission to know their limits:
That bravery isn’t always pushing through.

Sometimes, it’s recognizing what doesn’t feel safe — and walking away.

They need to understand themselves as not broken:

All brains are different. Not better. Not worse. Just different.

They need a new relationship with their inner world:

To thank worry instead of fighting it.
To understand it’s trying to help — and that they can gently take the lead.

They also need help making sense of sibling relationships:

“It makes sense your sibling annoys you. That’s okay. You can love them and need space sometimes.”

Because we are teaching them that relationships don’t require constant closeness — that love and space can exist at the same time.

And underneath all of it, they need the messages that anchor everything:

You are enough. Nothing you do can make me stop loving you.

These are the kinds of words that don’t just guide behaviour —they become the voice a child carries inside themselves. taken in Paradise by @drcotler

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7 months ago

My son didn’t cry when my dad died.
He still hasn’t.

I’ve been so confused about why he wasn’t grieving.

When we went to visit my mom recently, I told him that Papa wasn’t going to be there. He looked out the window and said: “That’s Papa’s truck…”

@drcotler helped me realize he is grieving.
Just not the way I expected.

Grief in kids isn’t always loud.

Sometimes it shows up in small moments.

In confusion.
In observation.
In quiet connection.

This story is for any parent who’s ever wondered:

Is my child really okay?
Are they processing what just happened?

Sometimes, silence isn’t emptiness.

It’s emotion finding its way out.

—

🎙 From Episode 507 of The Mom Room taken in Toronto, Ontario by @drcotler

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a year ago

We talk so much about getting through the hard. We talk far less about what it takes to come back.

Whether you’ve spent months or years navigating infertility, pregnancy loss, the death of someone you love, addiction, trauma, or physical illness, there are seasons when the energy it takes just to get through the day leaves very little for anything else.

Sometimes we withdraw because we need to. Sometimes because we’re overwhelmed. Sometimes because we’re in a kind of freeze, barely able to manage what’s right in front of us.

And while we’re away, life keeps moving.

People develop new routines, new friendships, new priorities. Not necessarily because they stopped caring, but because life continued while ours, in some ways, stood still.

And then one day, we begin to reemerge.

We feel ready to pick up the phone, make the dinner reservation, reconnect with friends, and find the parts of ourselves we thought we’d lost.

Only to discover that coming back requires its own kind of courage.

Some relationships need tending. Some need difficult conversations. Some have changed in ways we cannot undo. And some, painfully, don’t find their way back.

There can be grief in that, too.

I think we sometimes imagine that when someone is doing better, they need us less. But reentering the world after a prolonged period of pain or withdrawal can be profoundly lonely.

Sometimes we need to be welcomed back. To be invited again. To be reminded that we still matter, even if we’ve been absent.

So if you know someone who is beginning to find their way back, don’t underestimate what a simple invitation, a phone call, or an “I’ve missed you” can mean.

And if you’re the one coming back, give yourself time.

You don’t have to return as the person you were before.

You are allowed to find a new way of belonging.

If you’ve ever had to find your way back after a difficult season, what helped you reemerge? by @drcotler

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19 hours ago

Today is Pregnancy and Infant Loss Awareness Day.

A day that needs a place on our calendar precisely because so much of this grief remains invisible.

An estimated 1 in 4 pregnancies ends in loss. And yet, the pain and grief that follow are so often carried quietly, unseen by the world around us.

As a culture, we struggle to see what isn’t said or expressed in obvious ways. We miss the subtleties. The ordinary moments that can feel extraordinary to someone trying to conceive, someone who held a baby who died, or someone whose pregnancy never made it to term.

If you know someone who may be grieving today, or any day, ask them how they are. And then ask again.

You don’t need to fix it. In fact, you can’t.

A lasagna won’t make it better. Neither will a reassuring phrase or an attempt to find a silver lining.

But you can show up.

Ask them their baby’s name. Offer to light a candle together. Invite them to share their story, if they want to. Or simply say, “How are you? I’m here.” And truly listen.

Sometimes that’s all. And sometimes that’s everything.

And if it’s you today, or any day, I am so deeply sorry this happened to you.

If it feels safe, you are welcome to share your story, your baby’s name, or whatever you are carrying in the comments. I will be monitoring this space and removing comments that compromise its safety.

Because what we don’t see doesn’t mean it isn’t there. 🤍 by @drcotler

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2 days ago

We’ve never had more mental-health information. Instagram can give a mother the language for something she can’t name. A book can make her feel less alone. Someone sharing their story can make her feel seen. All of that matters.

None of it is clinical expertise, though.

Diagnosis is a controlled act, and it takes real training: judgment built over years, accountability, the kind of deep listening that catches what a person isn’t saying out loud.

I’ve worked in psychiatric emergency and inpatient units, and I’ve watched doctors, lawyers, and teachers with no prior history of mental illness become profoundly unwell after becoming mothers. Often they were the last to know something was wrong.

Someone else had to see it first.

That isn’t magic. It comes from years spent doing the work.

Our relationship with expertise is shifting quickly. There are more voices in this space than ever, and honestly, a lot of them are doing real good. But expertise itself is getting harder for people to spot. Even the word “psychologist” is starting to mean something different.

All those voices matter. Still, there’s a real difference between a voice you relate to, information you found online, and someone qualified to actually diagnose you.

When someone is struggling, they shouldn’t need a degree in mental health just to find the right person to help them.

Tanya taken in Toronto, Ontario by @drcotler

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2 months ago

As a maternal mental health psychologist and a mother of three, I’ve spent 20 years sitting with mothers and acutely aware of the misnomer “mom rage” as referring to angry moms- a term rarely assigned to dads..

And here’s what I know about “mom rage”:

We don’t become mothers and suddenly heal from everything that came before.

We don’t instantly have regulated nervous systems.

We don’t automatically know how to cope. And, We definitely dont need more scripts!!!

Instead, we are thrust into raising children
in a culture that still romanticizes motherhood,
while expecting women to do it all:

to work,
to care,
to clean,
to carry the mental and emotional load.

often without a village, and often while she has felt invisible, her needs too often buried sometimes since she was a girl

mom rage is a nervous system under strain.

A story that hasn’t been fully seen, supported, or shared.

And maybe the question isn’t:

“Why am I so angry?”

But - What is this rage communicating from a lifetime of being silenced?

Tanya taken in Toronto, Ontario by @drcotler

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6 months ago

Sometimes, when our children feel left out, something in us gets activated, too.

They’re not part of the big group. They weren’t invited to the party. They have one or two close friends, while everyone else seems to have ten.

And suddenly, we’re worried.

But whose worry is it?

Research suggests that the quality of close friendships can matter more for emotional well-being than popularity.

Of course, exclusion hurts. Loneliness matters. But there’s a difference between a child who feels lonely and one whose social circle is simply smaller than we imagined for them.

Sometimes our own childhood experiences of not belonging shape how we see our children’s friendships.

And without realizing it, we may be trying to protect them from a wound that belongs to our own story.

Our job isn’t to make sure our children are liked by everyone. It’s to help them build relationships where they feel valued, respected, and free to be themselves.

Sometimes we need to ask: Is my child feeling left out, or is this bringing me back to a time when I did?

Research: Narr et al. (2019), Child Development. by @drcotler

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5 days ago

Up to 90% of new mothers have unwanted, intrusive thoughts about their baby.

Almost none of them say it out loud.

What if I drop the baby? What if the baby stops breathing and I don’t notice? What if something happens while I’m driving? Thoughts like these can be horrifying, and most mothers assume the worst about what they mean.

An intrusive thought is not the same thing as wanting something to happen. It’s unwanted. It’s the opposite of what she wants, which is exactly why it feels like an intruder in her own mind.

I’ve sat with mothers in psychiatric emergency who were terrified to say these thoughts out loud, certain it meant they were losing their minds.

Here’s the part that actually matters: psychosis is a break from reality. A mother with an intrusive thought knows it’s wrong and is horrified by it, but in psychosis, the thought may not feel intrusive at all — it can feel like truth.

You can’t get that distinction from a Google search. It takes a trained eye for the intensity, the duration, what’s changed from baseline, how someone is sleeping and functioning and thinking. A clinician looks at the whole pattern, not just one thought.

Mothers need to feel safe saying “I’m having these thoughts” without shame. And we need clinicians who are actually skilled enough to hear what those thoughts mean.

Swipe through. And if this is you: having the thought does not make it who you are.

Tanya taken in Toronto, Ontario by @drcotler

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a month ago

I want my son to know that boundaries aren’t only about protecting himself. They’re also about the kind of person he becomes in a room with other people.

We talk a lot about teaching girls to say no.

I think we need to be just as intentional about teaching our boys what to do when something feels wrong—when the joke has gone too far, when the group is pushing them toward something they don’t want to do, when someone else is being humiliated, or when belonging suddenly seems to require becoming someone they’re not.

“That’s not funny” can be a complete sentence.

So can “Nah, I’m not doing that.”

And when someone else says stop, you stop.

I want my son to know that he can call me at 2 a.m. He can wake me. He can ask me to pick him up. He can show me the thing someone sent him that he wishes he hadn’t seen. And “you can always call me” includes online. If someone threatens you, pressures you, or says they’ll share something private, call me—even if you already replied or sent something. We’ll figure out the next step together. He is never bothering me when he needs help getting safe.

And maybe one of the hardest lessons:

Sometimes doing the kind thing will make you feel alone for a minute.

Sometimes belonging will be offered at someone else’s expense.

Sometimes saying “that’s not cool” will take far more courage than going along with everyone else.

But I don’t want to raise a boy who belongs everywhere.
I want to raise a boy who knows who he is wherever he belongs. by @drcotler

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20 days ago

I’ve been thinking recently about how easy it is to overlook our own growth.

We tend to notice the moments when we fall back into old patterns. When we react in ways we promised ourselves we wouldn’t. When we find ourselves overexplaining or taking responsibility for something that was never ours to carry.

But what about all the moments when we do something differently?

The small millisecond by millisecond moments when something shifts.

Like maybe a friend told you she wasn’t available, and instead of falling into that old pattern of thinking, “She must not like me anymore,” you reminded yourself that she might just be busy.

Or maybe your child was crying because of something that happened with a friend, and instead of rushing in to fix it, you allowed yourself to simply be there with them.

Or maybe, like me today, your children were fighting, and instead of raising your voice, you managed to stay calm. You helped them remember that they don’t have to be friends all the time, and gently helped them pause, reflect, and move on.

These moments are so small that we barely notice them.

But they matter.

Because growth isn’t always about the patterns we no longer repeat. Sometimes it’s about catching ourselves in those old patterns and finding, even for a moment, a different way forward. by @drcotler

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8 days ago

Mothers supporting mothers.

💕 This group might be for YOU if:

🌱 You are looking for support to help you cope with how different motherhood is from what you expected

🌱 You are looking for the tools to help foster a stronger relationship with your child (ren)

🌱 You are often reflecting on your motherhood journey and wanting to process and organize your mother narrative? (conception and/or birth story, your postpartum experience, or your own early childhood and how it’s impacting your parenting now?)

🌱 You are feeling lonely in motherhood and looking to connect to others on the same path?

🌱 You experience anxiety, anger, guilt, and you struggle with accepting these feelings

The groups are safe spaces for anyone experiencing some or all of the above.

DM or comment “Mom” for more information. by @drcotler

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11 days ago