If you don’t pee in front of your partner, think twice about having him at the birth of your baby.

July 21, 2016

 

We are on a girlie week-end, climbing hills in the Derbyshire dales, and staying in a bed and breakfast. We are all escaping motherhood for a day or two. Over breakfast one morning, a conversation begins about peeing in the company of our husbands. I am surprised to hear a few women say they have never had a pee with their husband in the room. It turns out they have never broken wind in front of him either. I kind of think this is an awesome feat of bodily control that I wouldn’t be able to achieve!  It reminded me of how different we all are.

But it got me thinking, that if you feel embarrassed to go to the loo with your partner in the room, what must it be like to try to have a baby with him in the room? Having a baby is not particularly alluring, it involve body parts, it involves smells and noises, it is not “lady like” particularly, or “sexy”.

I have been thinking these things for a while, but not had the courage to write them down. There is something, even in our modern day liberated lives, that is not okay about writing about women’s bodies as functional rather than objects of desire. So, as you read this, notice any discomfort you might feel, and ask yourself “why is it not okay to read about my body in this way?”

Dbirth stool labouro you pee in front of your husband? Do you change your sanitary wear in front of him? Do you break wind in his presence? Do you orgasm freely and loudly with him? If so, birthing in front of him might be easier. Because birthing is about your body parts, and it is about things coming out of your body, and it is about letting your body be released from your mental inhibitions.

To orgasm freely, we need to feel uninhibited. We need to feel that we are not being judged or watched, to not feel self-conscious. Birth is the same. I’m not talking about orgasmic, hippy dippy births (yes, orgasmic births actually exist). I’m talking about all births without drugs, or knives. Because your body needs the hormone “oxytocin” to birth without a drug or a knife, and oxytocin disappears if we feel judged, self-conscious or worried.

So, it stands to reason that if you get very self-conscious at the thought of your partner seeing you being anything other than sexy and alluring, you might struggle with his presence at the birth. You might not want him to see you grunting or sweating. You might not want him to see you breaking wind, weeing, or even letting out a little poo. Having some-one in the room, who makes you feel anxious or inhibited is not good for birth. So think very carefully about your partner’s presence, and if you’re not sure, then  my advice is to address it, discuss it, think about it, as part of your birth preparation. Sophie Fletcher, in her book  Mindful Hypnobirthing, is one of the few birthing books to even talk about the fact that he doesn’t have to be there. It is a choice. If you know that you do want him there, prepare for that. The Mindful Mamma classes spend a lot of time of partners’ role. Learn how he can help you to elicit and release your oxytocin via his connection and love. Mark Harris talks about this in his book “Men, Love and Birth”. Ina May Gaskin maintains that the kissing that got baby in there, can get baby out too🙂 Michel Odent argues that men’s presence in the birthing room might account for the rise in intervention. There’s no right and wrong. As I said at the beginning, we are all so different. But if you’re preparing for your birth, don’t prepare without addressing what it’ll be like for you to have him there, and what role he is going to play.

Mia Scotland

Birth Doula and Mindful Mamma hypnobirthing practitioner

http://www.yourbirthright.co.uk

What actually happens during a therapy session?

May 12, 2016

MiaI’m excited about this referral because the money has been arranged by a health insurance company, so neither of us need worry about money. They have released money for 6 therapy session. She enters my room. I have no idea what I am going to hear, or what I am going to do. I begin in the same way that I always begin. I hear her story and watch her and help her feel comfortable in my presence. She is wringing her hands. She sits bolt upright. She is tense. I digest her story, process it, try to make sense of it, quickly enough to be able to feed back in that one session what I think might help her. As I listen, I mentally pick out her strengths, they will come in handy at some point (a technique from positive psychology and hypnosis). I teach her some calming and relaxation techniques, after helping her to understand why this is so important to do (when we are stressed, our thinking changes – it becomes narrower, more judgmental, more skewed, less rational, and things just seem much worse than they are. This is a change that is real, and has been demonstrated on brain scans). We record a relaxation session on her phone, tailored just for her. She told me she never relaxes, but in that five minutes, she did. She takes away the recording to listen to regularly (this activates the parasympathetic nervous system, triggering a calming response, helping her to think more clearly and calmly).

She comes in again the following week. She tells me that she has a major challenge on that week-end, so can we please help her cope with that. We do some cognitive work (challenging her negative beliefs about the stressful situation). We do some reframing (helping her to think of it differently). We do some behavioural strategy work (helping her to develop alternatives) and then we do some imaginary rehearsal (or rather, hypnosis, to get her to imagine herself actually acting out the coping behaviours. The brain needs to visualise to realise. Just talking isn’t enough).

We do some role play to cement the new cognitions (I give voice to the scary thoughts, and she answers them with the new ways of thinking). This bit is quite fun, and it gives me a really good idea of whether the work we have done so far has been understood by her. It has.

I then finish off the session with an NLP/hypnotic technique (neuro-linguistic programming technique) to cement at a deep level, the new behaviours. It’s called the Swish pattern technique, and I use it quite a lot. I can see in her face that it has worked supremely well (because she looks confused as she tries to bring up the old image of her previously anxious self. Her brain can no longer access it).

The next session, she comes in smiling. She relaxes onto my sofa. She tells me she is feeling good. She tells me she had a good week-end. It all went fine. It’s not that she coped with, or managed her anxiety, it’s that it wasn’t there in the first place. She tells me that it just didn’t really figure in any way. She doesn’t really know how it changed. I tell her that we had “reset the system” back to her old, relaxed happy self (that was the strengths that I had picked up on in the first session) but I don’t think she understands. This happens a lot. People get better, but they don’t know why or how. I do, but I don’t bother trying to explain it, as that would somehow take the magic out of it.

So, there’s no need to arrange a further session. She will call me if she gets any symptoms back again, and we will hypnotically release the past traumas that trigger her anxiety (using the Rewind technique). But we won’t do that now, because she chooses to just enjoy life and get on with it again (I did give her the choice).

So, the planned 6 sessions became 3. This happens all the time. Because when I introduced hypnosis and NLP into my cognitive behavioural model of working, change began to happen super-fast. And super easily. The adage “no pain no gain” is simply not true.  This super speed may not be good for my income ( I lost out on three sessions worth of pay), but it’s great for my work satisfaction.

Mia Scotland, Clinical Psychologist

www.miasscotland.co.uk 

 

“I’m scared I’m going to harm my baby…”

April 28, 2016

mia brochure photoWhat do you say when you hear the words “I’m terrified that I’m going to harm my baby”

Those words are ones that would be hard to say if you’re a mother. But if you’re a professional, be it a midwife, a health visitor, a doula or a counsellor, they can be hard to hear too. Those words represent an ultimate taboo.  A mother wanting to harm her own baby…..

But just wait a minute. If you are very astute, you will have spotted my deliberate error there. Can you see it? They are not the same thing. “I’m terrified I’m going to harm my baby” is not the same as “I want to harm my baby”.

If you hear a mother say “I’m terrified I’m going to harm my baby” the chances are she is suffering from an anxiety disorder, and she is not a danger to her baby. She is about as dangerous as some-one with fear of heights, who stands near(ish) a cliff and says “I’m terrified I’m going to jump off”.  You wouldn’t call the crisis team in this instance would you? Instead, you might say “no you’re not, you’re just scared”. It’s the same with mothers. If a mother is anxious (and especially if she is suffering from perinatal or maternal Obsessive Compulsive Disorder) then she might talk about suffocating her baby, but she can be reassured that she isn’t mad or bad, she is scared.  And of course, if you make the mistake of reacting like she is mad or bad, and call the crisis team, you certainly aren’t going to ease her anxiety!

To find out more about perinatal mental health problems, come to my workshop for birthing professionals on Friday 10th June 2016. For details, click here 

Mia Scotland, Author of “Why Perinatal Depression Matters” and Perinatal Clinical Psychologist.

My All Time Top 5 Tips for Birth Preparation

April 13, 2016

mia brochure photoAfter over 10 years of teaching birth preparation classes, and having taught over 1000 couples, here are my definitive five top birth preparation tips:

1. Get the birth companion prepared too. As a mother, you have the benefit of birth hormones to help you go into the zone, and to help you forget the pain. But your partner doesn’t have this lovely little tool kit for birthing. Because he wasn’t designed to birth a baby. There is a teeny weeny chance that he might get a rush of adrenalin, and try to help with “action man” bravery, when what you need is stillness and calm. If he is going to be there, he needs to prepare for this.

2. Release your fears and negative assumptions about birth. Our society has soaked you in a culture of presuming that birth is a horrific ordeal. You need to let that conditioning go, so that it doesn’t affect you too much on the day. This is true for a zillions of different reasons that science has demonstrated, but that I haven’t got the space to go into right now. One little example is that if we expect pain, our brain actually creates pain. Another is that if you are scared, your labour lasts longer.

3. Take your environment very very seriously indeed. I cannot sleep in a busy security queue at an airport. I can sleep very quickly, tucked up in my own bed at night. Birth follows the same principles (there are so many ways in which birth is similar to sleep – to0 many to go into now). Prioritise your birthing environment to create a spa like feel in the very special room that you are going to meet your baby in.

4. Condition your body to be able to respond with an automatic relaxation response to specific triggers. In NLP, this is called anchoring. In psychology, it is called conditioning. It is the basic technique that all good advertising is based on, and it works. It is so easy, but so effective. Hypnotic relaxation PM3s are perfect for this. You can also anchor yourself to a smell. Or a touch. You do the anchoring in your pregnancy, and then on the day, you generate the trigger, and your body will respond automatically.

5. Know your rights. So many second time mums say “I didn’t realise I had a choice” or “I didn’t know what they were doing” or “I know I don’t want to do that this time”. You know what? The NHS is your servant. It is there to support you, offer you advice, and listen to what your preferences are. They literally can’t touch you without your consent. You have the power to always say “not yet thank-you, I want to have a think about it first”.  Whether it is a blood test, an induction, a sweep, having your waters broken, seeing a doctor instead of a midwife, you choose. Birth preparation is about empowering yourself to enable the midwives to help you to have your choices and needs met.

These are the five things that we have prioritised in our  Mindful Mamma hypnobirthing class. It is one day, but it is packed full of all the above. There is the wonderful Mindful Hypnobirthing book which you receive when you book your place. There are 9 MP3s to help you release your fear, build a positive mindset, and anchor relaxation. There is exclusive access to a website with handouts, infographics and bonus MP3s. I run the class near Nottingham and Leicester, in a lovely venue in Melton Mowbray. There some of the testimonials and birth stories from people who have done my class here. Enjoy🙂

Mia Scotland

Clinical Psychologist, Hypnobirthing antenatal teacher, Birth doula

www.yourbirthright.co.uk 

 

Why Hasn’t Birth ‘Debrief’ Worked Very Well? 

March 15, 2016

Birthing Awareness

Maybe you think it has?

Every since I trained as a midwife in 1994 one form or another of ‘birth debrief’ has taken place in the UK.

Recent research suggests that what we have been doing all these years hasn’t worked very well at all.

The ‘confidential inquiry into maternal death’ report (2015) is very clear that postnatal mental health issues are becoming a leading cause of death following child birth.

What can be done?

The Maternity Review (2016) has pointed towards increased investment in our NHS postnatal service, a call to action which is long overdue.

Mia Scotland (clinical psychologist, doula, hypno birther and author) and I are choosing to make a contribution in this area.

On Thursday 9 June 2016 we are running a co-led workshop exploring this very important subject.

Details regarding what we are going to cover will follow, but we will certainly be taking about…

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Pass The Bomb: who is going to contain your anxiety when you are with your newborn baby?

January 26, 2016

iStock_000064471321_SmallNew parents are anxious. And according to research, they are getting more and more anxious. I often hear cases of mums unable to sleep because they are terrified. Terrifed that their babies aren’t breathing. Terrified that the room is too hot. Terrified that baby hasn’t fed enough. Terrified that they will damage their baby. Dads are getting postnatal depression too, at rates almost as high as for women. They are scared too. I want to talk about a psychological piece of gold, that can ease anxiety, but that new parents are lacking in our modern lives.

Containment is a psychology term that basically means; the process of stopping anxiety from bouncing around the room.  Containing situations and emotions is something that all good parents do (and therapists too). It’s not easy to explain, but I’ll give you an example of when containment is NOT happening. My son may come to me in a flap because his friends have said to him (in a flap) that he has to start job hunting now, because a teacher said to his friends (in a flap) that jobs are very competitive and they need to take this seriously and start job hunting now. I can continue the flapping by saying “what? Are you serious? Now? That’s crazy. Can it really be that bad? Oh my goodness, I don’t know what we are supposed to do with that information, it’s a crazy world out there”. And in my exasperation, I tell my friends, who are also parents, and pass the flapping on. The anxiety continues down the line, because no one has contained it.

Or, as a parent, I can provide some containment. In doing so, the anxiety disperses. I do this by “containing” my own feelings of exasperation or anxiety, and I can calmly and warmly say “honey, that sounds very pressurising, I can understand that you’re worried (empathy). But you know what? It’s going to be fine, because you have at least a year before you need a job, you’ve already got a great CV, and I’m going to help you get yourself sorted. Shall we take a look this week-end?”  He relaxes, and the “containment” goes back down the line, because he tells his mates “actually, we do have a year, and we’ve got our CVs done already, and I’m not worried about it” and so on. Containment kills anxiety.

I was watching an episode of the British Sitcom “On the Buses” recently. It’s an amazing watch, because it is a rare glimpse into social history. It is set in working class London, in the early 1970s. It is clear, watching this, that it was normal to go through your first pregnancy, birth and babyhood, whilst still living with your parents. This was common before the 1970s, because newly weds couldn’t afford their own house. In one particular episode, a pregnant woman and her mother were chatting about the baby in a tiny kitchen, which serves as a wash room and a living room all in one. The pregnant woman was expressing anxieties about becoming a mum. The mother’s mother responded with something along the lines of “I’ll be ‘ere anyways, so you ain’t got narfin’ ta worry abart” (I made that bit up, I can’t remember exactly what she said). She was replying with reassurances, in a tone that kind of said “I totally get why you’re anxious, because I was” (empathy) and added “but really, it is so easy to look after a new baby, that you have nothing to worry about”. She was nonchalant, but empathic too, and containing.

Nowadays, new parents go home to their own house when they have their baby. And they don’t really want the mother in law around too much. And they don’t want her advice, because advice has changed so much. So they go home and do it themselves. Here-in lies the danger: What they don’t realise is, they have no-one to contain the anxiety. This is critical, but overlooked. Hazel Douglas defines containment as being “when one person receives and understands the emotional communication of another without being overwhelmed by it, processes it and then communicates understanding and recognition back to the other person. This process can restore the capacity to think in the other person.” Thus, it is a powerful tool for helping the person become unstuck from paralysing anxiety, to help them become functional again, to “think” again. Because, you know what? Working out what to do when a baby cries, learning how to pick up a baby, rock a baby, feed a baby, change a baby, keep it alive, is quite a big task when you are new to it.

And when there is no-one around to contain the anxiety in the middle of the night, it all gets a lot more stressful. And if you are scared and anxious, you are passing that on to your baby. Your baby picks up on “something is the matter”. So your baby is more likely to cry. So it gets worse. What you need, is someone to come in and contain the situation. Some-one who has done it before, who can calmly, empathically and warmly turn the situation around with one look and one smile. She sprinkles magic fairy dust into the room, just like a real life fairy godmother. Who is going to do that for you? Traditionally, it would have been mothers, sisters, midwives or aunties.

Nowadays, fathers are courageously trying to fill this gap. They are mucking in with the night time nappy changes and the job of caring for the baby. That, in itself, is a big job if you’ve never done it before. But dads, you have an extra job. You are also there to support the mother, so that when she is crying on day three of the baby blues, you can hold her in your arms and tell her that you love her. All very well, but can you tell her, knowingly, that it’ll be okay? Can you tell her, from experience, that it’ll pass? Can you tell her, and feel, that you are calm and strong and capable of handling all of this? Can you contain the situation?

Probably not. Because you have never done this before, either. You are tired from the birth too. You are on unknown, scary territory. You haven’t got the benefit of wisdom and experience on your side. You need some-one to come in and say to you “it’ll be okay, hold her in your arms, tell her you love her, let her cry all over you, you are doing an amazing job by just being there for her”. Dad needs containment too, so that he can be there for the mother. The mother needs containment so that she can be there for the baby.

So, how can you build in the psychological gold nugget that is “containment” into your postnatal birth plan? Well, you haven’t got time to wait for the NHS to provide it in the form of regular midwife visits postnatally with continuity of care, so you need to do it yourself. Think about which members of your family help you feel safe, nurtured, and cared for. Bring them in to help. Ask them to move in! If no-one is available, think about paying for this kind of help. Lactation consultants, postnatal doulas, night nurses, private midwives, all do a fantastic job. Postnatal doulas are not expensive. They are trained in all aspects of new parenthood, and they are exceptional at taking care of your needs so that you can take care of your baby. This will take the pressure off the father too, so that he can remain strong, and enjoy the process.

Think twice before you spend your money on a travel system, or on pretty wall paper with matching bedding. Think about your emotional wellbeing before your physical wellbeing, and you, your partner and your baby can thrive as early as possible in your incredible journey as that most precious thing in the world: creating your very own family.

mia brochure photoMia Scotland is a Clinical Psychologist and author specialising in the Perinatal Period. See her website at www.yourbirthright.co.uk or buy her book, Why Perinatal Depression Matters from Pinter and Martin.

Lambs, mothers and keeping them together

January 18, 2016

mia-websitetinylphotoMy friend’s daughter announced last year that she wasn’t going to eat lamb anymore because it seems cruel to eat those cute things bouncing about in fields. I responded in a very over excited way, that lamb is the least cruel farm animal product you can eat. And I really mean this, and I want the whole world to know about it. The reason is this: Lamb is the only farm animal that is not repeatedly removed from its mother, and that is truly free range. Keeping mothers and babies together is a passionate part of what I do, and that passion extends to what I eat (I’m so sorry, if you are a vegetarian reading this, it might seem very odd to you, that I would eat meat at all). We have been separating mothers from their newborn babies for many decades, and part of my work is to help mums have skin to skin contact immediately after birth. Thanks to the hormones running strong in the mother, this is almost always a joy. I have recently seen numerous campaign videos suggesting that when milking cows are separated from their calves soon after birth, they show signs of distress. It is upsetting to watch. The dairy industry separates mothers and calves all the time. The chicken industry separates mothers and chicks, even before hatching. When we tried to breed ducks in our garden, I wanted them so much to hatch under their mummies tummies (not a lamp), and to follow their mums around frantically, hopping over tufts of grass and large stones (not stay chirping in a cardboard box). It was a delight to see. Lambs are the only farm animals that are routinely able to frolic around in open fields, with their mummies, eating nature’s grass, happy as a pig in muck (see what I did there?).  That’s a delight to see too. You can tell that I am a little “fluffy” about this whole issue, not unlike my friend’s daughter who declined any lamb product as a result of her heart strings being twanged by the site of frolicking lambs. I have a friend who is a sheep farmer, and when I was waffling on about this one day (over one glass too many of the vino), he seemed very uninterested in what I had to say. And yet, sheep farmers, this is a marketing gold mine! You should milk this little gem for all you’ve got (see what I did there too?). It is arguably less cruel to eat lamb, than it is to drink a glass of milk. Lamb is increasingly the more expensive meat on our shelves, and there’s a reason for that. Lamb equals free range farming, as nature intended, with animal welfare top of the list. So, if you insist on eating meat, and you want to eat with animal welfare in mind, choose lamb.

Torturing new mothers and then wondering why they get mentally ill.

December 8, 2015

 

Woman SleepingTorturing new mothers? Who does that? Well, as a society, we all do. I’m not kidding, I’m perfectly serious, and I’m going to stop mincing my words and say it how it is. We torture mothers.

Sleep deprivation is a method of torture that has been used for at least 500 years, and is still used today. It was used extensively in Guantanamo Bay. The difference between sleep deprivation in Guantanamo bay and in new mothers is that no-one is systematically and intentionally hurting new mothers. But the effect is the same. Sleep torture is designed to create psychological changes, which are supposed to encourage the victim to submit, to lose their sense of reality, and to talk.

Chronic sleep deprivation is not good for you. It leads to cognitive impairment, anger and irritability, anxiety, and even psychosis.  Yes, you read that right. Chronic sleep deprivation is known to cause psychosis. Puerperal psychosis in new mothers is not common thankfully, but it is dangerous.  I’ve been lucky enough to attend a few study days on perinatal mental health recently, and they have all included really valuable talks by people who have recovered from severe postnatal depression, post traumatic stress disorder and psychosis. What I noticed was that they all had one thing in common . They all mentioned lack of sleep as a factor in their illness. The lovely Sinead Willis talked about “lack of sleep started to catch up with me….I couldn’t sleep more than an hour at night and I became very disorientated”. One of the effects of sleep deprivation is disorientation, or a feeling of “altered reality”. At another talk I was lucky enough to hear, the mother told us that she hadn’t slept at all for the first three days of her baby’s life, but no one noticed, because she was in a private hospital room on her own. She developed psychosis within a matter of days.  Elaine Hanzak, author of “Eyes without sparkle” talks about the fact that during her treatment, she would look forward to her Electro-Convulsive Therapy sessions, because “they have to put you to sleep first….bliss”.

Chronic sleep deprivation is when you have no opportunity to make up your sleep debt. You go on, night after night, suffering from not enough sleep. Acute sleep deprivation is when you lose sleep for one night, but you can then catch up. Even acute sleep deprivation has a marked effect on our mental health. In one study by Walker and colleagues, healthy young students were split into two groups. One group were sleep deprived, the other group slept normally.  The next day, both groups were shown disturbing, upsetting and gory pictures. The researchers found that there were significant differences in the brain activity of the two groups, as measured by MRI scans. The sleep deprived group showed reactions similar to anxiety reactions. Their amygdala lit up like an alarm bell to the disturbing images, firing off stress hormones, whilst the normal group’s brain showed a more balanced reaction, with the parts of the brain that “panic and worry” being balanced by the part of the brain that “reasons and rationalises”. In the sleep deprived group, their ability to process and mediate the anxiety was damaged.

People have always thought that anxiety and depression causes disturbed sleep. But this research suggests that lack of sleep can cause anxiety.  All on its own, and in only one night.  Whilst new mums aren’t shown disturbing images by scientists, they do have disturbing images all of their own. Worries and concerns about the baby, feelings of guilt, not being good enough, intrusions of hurting the baby, concerns about baby’s feeding, and so on. And of course, once anxiety sets in, it becomes more difficult to sleep, increasing the chances of depression setting in, and a vicious cycle begins with a force of its own.

With all this in mind, is it any wonder that we have such high rates of anxiety, depression, and psychosis postnatally? Women usually give birth overnight, sometimes over two or three nights. They are then put in a busy maternity ward with lights on, other women and babies crying, constant interruptions from staff and so on. Or they are sent home alone with just a very tired husband. Either way, they have a baby with them, who they need to keep alive, learn to feed, and look after. On no sleep.  Then, when the father goes back to work after his 2 weeks of paternity leave, it is perfectly acceptable in our society for her to say “I’ll do the night feeds, because you have to work all day”. She isn’t understanding the value, the necessity, of her sleep for her mental health. Neither is the father, or the health visitor, or society in general.   Her sleep debt builds, increasing the risk to her mental health.

In other cultures, mums are made to rest, recuperate, stay in bed, and do nothing but get to know baby. They are fed, washed, pampered with hot stone massages, and so on. Almost all non-westernised cultures have a ritual similar to this, which lasts about 40 days.  In the West, mums are not made to rest. They are expected to go on as normal, with the washing, the school run, losing baby weight, going shopping and so on.  Mums are told “sleep when baby sleeps”. However, this simply is not good enough. Because mum needs to eat, and she needs to shower, and she needs to get dressed sometimes, and she needs to go to see the health visitor and have baby weighed, and baby might only sleep for 20 minutes at a time. Then, when dad goes back to work, it gets even more chronic, because she offers to do the night feeds so that he can get up and work the next day. The importance of her physical and emotional health is ignored, at a high cost to the devastation that perinatal mental illness causes, and a high cost to the NHS.

Let’s stop torturing mothers. Let’s stop ignoring the problem of expecting new mums to get back to normal. They are not normal, they are super important, and we need to value them and treat them with the greatest respect, if we don’t want them to break into a million pieces, shattering the lives of all those around them. The NHS needs to prioritise maternal mental health, not just with adequate treatment facilities once the damage is done, but also with prevention in the first place. Proper paternity leave, decent postnatal wards with midwives who have time to care, regular home visits, continuity of care. Change needs to happen in attitudes as well. We need to start telling other people how important it is, to look after mum. Encourage partners to “put mum to sleep”. Tuck her up in bed with a chamomile tea (or a G and T) and tell her to stay there. Turn the lights off for her, bring her an extra pillow, tell visitors to go away because she is sleeping, bring the baby to her when he or she needs a feed. The cost of not doing so, could be her mental health.

Mia Scotland, Clinical Psychologist, Author of “Why Perinatal Depression Matters”

Can a two year old be traumatised?

October 28, 2015

Can a two year old be traumatised?

I was asked recently how to help a two year old settle at night. The wonderful book “The Rabbit who Wants to Fall Asleep” wasn’t working, along with countless other things that the beleaguered parents had tried. This came up in conversation during a mindful hypnobirthing class, and myself and another CBT therapist both got completely side tracked, and set about trying to find the answer to the problem, by asking the parents (who are tired, sick of advice, and frankly, stuck), lots of questions about their troublesome two year old.

Given that I was supposed to be running a hypnobirthing class, I had to curb my curiosity, and my urge to help, and get the subject back to talking about birth and babies – which was the object of the day. However, my brain remembers that there was unfinished business, so I’m going to finish it in the form of this blog.

It got really interesting when they said that their little girl’s sleep patterns had been fine, until, during the summer, their cat had jumped in through the window, onto her bed, in the middle of the night, waking her up with an awful shock.

Since then, she fusses about going to bed, she imagines all sorts of things that are scary in her bedroom, and she waked up in the middle of the night, and can’t go back to sleep unless she gets into her parents bed. Sound familiar?  Of course it does. This is classic two year old behaviour. At the age of two, there is a strengthening of the child’s “attachment behaviour” (there is also one at about nine months old).  This means that she is more likely to get clingy and want to know that her parents are around, so they can keep her safe. It kind of makes sense, because at the age of two, a child becomes more independent physically (she can run much faster) but she is also becoming more independent psychologically, because her neocortex is developing at a very fast rate. This means she can plan ahead, be persuaded into things by others, she can plan exciting things like how to run away from home and have an adventure, and so on.  Thus, she is arguably a little more vulnerable to getting lost, or getting eaten by a wolf.  Nature protects her by providing an in-built mechanism to keep her parents close.  The attachment process is even stronger at night, because the child needs to be kept safe from the dark. Her imagination of “monsters” is formed at this age (tigers, wolves, strange men from warring tribes, etc.).  These monsters are as real to her, as dangers of heights, flying, spiders, or whatever your personal fear might be. She just does not feel safe, and she can’t explain why, just as we can’t explain why we don’t feel safe in the presence of a tiny cute spider that we know can’t harm us.

So, unfortunately, in the case of our little girl and her cat, this cat jumped on her bed at a critical point in her development. It fast tracked and heightened her need to know that her parents are close in the middle of the night, and made her needs for a strong attachment much stronger. However, I also think it traumatised her. This means, that the experience got “wedged” in the limbic system (the alarm signal of our brain) and hasn’t been processed as a memory. In other words, when she goes to bed at night, her alarm system triggers “oh no, this is where I’m not safe, this is where scary things happen to me”. Her alarm system is trying to protect her, but it has got it wrong. Her alarm system thinks that she is still in danger, when in fact, she is perfectly safe (the window is closed, and the cat cannot jump on her again).  However, with her amygdala firing off, she is struggling to settle at night, even when a lovely hypnotic cd is being played.

In therapy, when I help a person recover from trauma, the single most important thing is for the person to feel safe. You cannot recover from trauma while your alarm system is firing. It will listen to nothing else, no logic, no reason, no nothing. To get the brain to “listen” and process the memory, we have to calm the amygdala first and foremost.  I do this with relaxation and hypnotic techniques. But in the case of the little girl, the thing that helps her feel safe is the proximity of her parents. So, here is my advice for how to help this little girl settle at night, and how to help her parents get some much needed sleep.

  1. Go to bed with her (or sit in the room with her) and stay there silently, while she falls asleep. You can use this time to practice your meditation, or mindfulness techniques. You can use this time to notice her breathing near you, to notice the warmth of her body, to notice how jittery and lively your own mind is, and to learn to calm it. Do not focus on whether she is sleeping or not, as she will notice this tension. Just focus on your own wish to relax and be mindful. You might even get a power nap yourself. The need to do this will pass. It might take a few months to be honest, but a few weeks might be enough. At some point, she won’t care whether you are actually in the room or not, so long as she feels safe, and so long as she feels sleepy. The argument about whether you can “spoil” a child, or whether she might be attention seeking, or “playing you” is worthy of a whole other blog.  Just trust me for now, that if you meet her needs (for security) without additional gains (such as playing, or fun), then you will not make things worse.
  2. At other times in the day, talk to her about the cat incident that “happened when you were so little” or “that happened so long ago” or “that cannot not happen any-more”. Get her to tell the story, draw it, or act it out between the two of you. Make it a game, make it fun. Finish the “story” with a definitive “it’s over”. For example, if you are “playing” the cat game, and you are the cat, make a point of being thrown out of the room, and not ever being allowed back in. Or she can pretend to be “mummy” and cuddle her doll better, after the doll got a shock from the cat, and explain to her doll that the cat won’t do that again because the window is locked now.  (Being cuddled better might be important, because in my experience, a lot of trauma comes from a sense of having felt alone at the time of the trauma). You won’t need to do this more than a few times for it to have done the job of helping her brain to process the event as a “memory” rather than an ongoing “danger”.

I know that these parents have the wholehearted sympathy of so many parents who are tired, exhausted, confused, fed-up, worried, beyond caring, bewildered, all because they have the joys of a two year old in their lives.  Good luck with it, and know that it really does get an awful lot easier as they get older J

Happy mummy, happy baby

September 1, 2015

So, I’m eating a slice of toast while reading a blog from my facebook page this morning.  I can do that now, because my children are older.  I can even finish my cup of tea, and make sure that I am wearing appropriate clothes to walk the dog in. I no longer find myself rushing around to make sure my children have their hats and scarves on, and then to go out realising I am wearing no jacket.  Putting others first seems to be what mothers do, to the detriment of their own mental health. This is partly related to guilt.  Guilt is a big deal in new mothers.

So, as I read this blog about babies’ mental health, I am struck by how easy it would be for this blog to make mothers feel even more guilty.  It is littered with phrases such as “what parents do profoundly shapes who we will become” and “early experiences matter – a lot”. It tells us how our handling of our babies shapes their personality, their future mental health, their critical thinking skills and so on.

Then it goes on to say that the good news is that “nurturing strong mental health in young children is not a specific undertaking in which parents need to engage – as if it were a “job” or task.  It is how parents are with their babies that matters….delighting in the joy of young children’s daily discoveries”.  Well, frankly, that this is good news is debatable.  If it were “a task” it would be easier to complete.  You could have a checklist in the morning, and make sure you have done your jobs.

  1. Dress baby
  2. Feed baby
  3. Smile at baby and make eye contact

But no.  Now, we have to “delight in the joy of young children’s daily discoveries”.  Actually, if you have ever tried to get a toddler out of the house on your own, with a baby still in their jumpsuit, having to get to pre-school on time, not having eaten yourself, or finished your cup of tea, with baby sick still on your shirt, and your toddler says “look, a leaf on the ground”, you do not delight in this.  You do not feel like cooing, smiling and delighting in your toddler’s very slow progress along the pavement.  You grit your teeth and say “come on” in a voice that is far too squeaky, desperately wanting your toddler to move it, so that you won’t be late again.

The blog is correct. It is the delight and joy that people share with their babies, that helps the baby develop.  Mother and baby create a “dance” of interaction.  With each positive interaction, the baby’s brain fires more neurons, lays down the foundations for feeling loved, trusting and explorative.  Nature designed mothers to look into their baby’s eyes and feel joy, for this very reason.  But nature did not design us to be able to do this on our own in a rather large, otherwise empty, house.  It is not fair to tell a mother who is doing this job on her own, that she “just” needs to be joyful, if you expect her to do a job that is stressful, lonely, unsupported and practically impossible, and then ask them to be joyful while they are doing it.  Not only do we as a society do just that, but we then actually have the gall to suggest that if they aren’t joyful they are damaging their baby’s mental health!  You cannot feel guilty and joyful at the same time.   This is because stress hormones (associated with feelings of guilt, shame, depression, anxiety, worry) and very different to calm and joy hormones (associated with relaxation, mindfulness, connection, warmth, compassion, mutual joy and sharing).  Stress cuts across joyful feelings immediately because nature designed us to prioritise being alive over being happy.  So if a mother is stressed, she will find it harder to “delight in the joy of young children’s daily discoveries”.  When a mother has her baby, she is recovering from a birth physically and psychologically, she is learning to adapt to being a mother (being responsible for a little being, no longer able to put her needs first, no sleep and so on), she is  grieving her old life and adapting to her very different new life, she is having to manage the housework, cleaning, ironing, cooking, school runs, worrying about her weight, worrying that her husband still feels included and loved, and so on.  This is too much for a new mother.  She needs to rest.  She needs to be looked after.  She needs people around her.  She needs her privacy.  I have to say, a little part of me envies Mormon mothers (yes, I actually wrote that!). While some people think it dreadful that they should share a husband, I see it slightly differently, because in Mormon households, the mother is not alone. Imagine if you always had other “wives” around you in the house, to help with housework. Imagine if you only had to be responsible for feeding your children one or two days per week, because some-one else is cooking the other five days.  Imagine if, when you need a wee, but your child needs to put their shoes on because you are late, imagine some-one saying “I’ll do it, you pop to the loo”.  Imagine, when your child has had a dreadful tantrum, and you feel like you’ve been dragged through a hedge backwards, some-one says “you poor thing.  I’m going to make you a cup of tea, and settle your toddler down with a drawing for you”.  Imagine, when you are about to shout at your toddler because you are tired and wired, you can turn to some-one and say “I feel like screaming” and she can laugh and say “I know that feeling.  Off you go, I’ll spend 5 minutes with her”.  Imagine on a day when you have a cold and you feel wretched, a woman says firmly to you “go to bed and stay there.  I’ll do this”.

The point isn’t that we should become polygamous, the point is that society needs to look after mothers if we want mothers to look after babies.  The research shows us that mothers who feel the “joy” of parenting do a great job raising kids.  However, one cannot force “joyful” parenting on some-one, especially not by increasing guilt.  You create the conditions for joy.  In response to the research, society has to do a great job taking care of mothers. The flipside of joyful parenting is sad, scared parenting.  Perinatal mental health problems are on the rise, and we know that this is not good for babies.  The government is addressing this by increasing “identification” and “treatment”.  This is important, but we are putting sticking plasters on a bigger problem.  Isolating and burdening women is the problem.  And it’s affecting fathers too now, as they are increasingly expected to juggle full time work, house, children and looking after mum.  They are getting sick too.

Stop the guilt. Stop the scare mongering.  Prioritise taking care of our families, so they can thrive in joyful, relaxed interactions.  Simples.

Mia Scotland, Clinical Psychologist and Author of “Why Perinatal Depression Matters“.

Website:  www.yourbirthright.co.uk.