Posts Tagged ‘anxiety’

Meerkats and Perinatal Mental Health: What is the one thing I do when meeting some-one who is depressed or anxious?

November 9, 2016

It’s help them to calm their brain.

meerkat-alert

Picture a meerkat, up on the tips of his feet, eyes and ears peeled for danger. Red Alert. The meerkat is on patrol for the night. His brain and nervous system are hypervigilant, sensitive to all dangers, out to protect his clan.

Now picture the other miakats (that’s how I like to spell it!). They are asleep. They are warm and curled up, maybe cuddling up to a fellow miakat. They feel safe. They feel relaxed. They are resting and reenergising for the next round of activity.

They swap. Once the patrol miakat has done his patrol, he can rest, while some-one else takes over patrol duty.

The problem with anxiety and depression, is that the brain’s alert/danger system is stuck to “on”, leading to exhaustion. This alert/danger system shows itself in the inability to sleep well, the constant worrying about whether you are good enough, or whether your baby is healthy enough, or whether other people are talking about you, constant restlessness mixed with tiredness, irritability, and so on.

So, the first thing I do when I meet some-one who is depressed or anxious, is help their brain to switch from the alert/danger system, into the calm/relaxed system. I relax them in session, and then I give them a relaxation MP3 to listen to every evening as they go to bed. It’s like a sleeping tablet that has no side effects. It’s like a respite for the brain, from that constant struggle. It’s the start of things getting better for them.

meerkat-sleeping

Mia Scotland

Clinical Psychologist

http://www.yourbirthright.co.uk.

Have you written a postnatal care plan yet?

October 10, 2016

You wrote a birth plan, because birth is a big deal. But did you write a postnatal care plan? After your baby is born, your whole body and mind are in transition. Transition can be so tough, it’s even got a psychiatric label attached to it (Adjustment Disorder). Your body is physically transitioning in crazy, magical ways, and you are mentally transforming to get used to being instantly interrupt-able, having strange sleep patterns, putting yourself second, and grieving your lost carefree past. You are learning to know and love your baby. (Honeymoons were designed to help you love your new partner. Babymoons should also be designed to help you love your baby). Your brain is processing the birth. The list goes on and on and on and on. So, don’t just go home and hope for the best. Here is an example of what your postnatal care plan might look like:

“My Postnatal Care Plan

I have written a postnatal care plan because I very much want to enjoy my first few weeks getting to know my baby. I am aware that I have a tendency to do too much, and to feel guilty when I’m not getting stuff done. I want to ensure that this doesn’t happen following the birth of my baby, and so I am planning how to take care of myself in the first two precious weeks with my baby.

Generally, I wish to spend time skin to skin with my baby, I wish to establish breastfeeding, and I would like my husband to be an integral part of this with us.

Immediately upon coming home:

My husband would like to carry me and our baby over the threshold.

I would like a warm bath with rejuvenating bath salts, and then I would like to get into fresh (new) pyjamas and into our king size bed with new fresh sheets, and my baby.

I would like the lights kept low, my phone and my remote control next to me.

I would like to eat a huge, warm, filling meal of cottage pie and peas, washed down with camomile tea and a glass of champagne.

I would like my husband to join us as much as possible in bed.

For the first two weeks after coming home:

I would like visitors to stay away for at least 12 hours, apart from the midwife and my lactation consultant, who I have pre-arranged support with.

In the first three days, I would like very close members of my family only, to visit.

I do not want my baby to be held by anybody else in the first three days, other than her father.

We have arranged for a food delivery of fresh fruit, salads, sandwiches, chocolates and champagne. There are plenty of ready cooked meals in the freezer too.

I have arranged for a cleaner to come in every other day to tidy and clean the house, as per my husband’s requests (she will not clean our bedroom).

I have specific herbal/homeopathic remedies that I will be taking each day.

After the first three days, I have arranged for a postnatal doula to come in and provide emotional and practical support every three days.

My husband will help to ensure that I get plenty of rest, by regularly encouraging me to go to bed, and ensuring that the household and visitors are taken care of.

My husband will take a few hours out of the house each day, to do something to help him to feel refreshed also.

According to how I feel, I plan to spend most of the first two weeks in and out of bed. I might take a walk or potter around the house if I feel restless, but if not, I will stay in bed to recover and adjust, both physically and mentally, and to help me to fall in love with my baby and establish breastfeeding.”

What do you think? If you are thinking “that’s a bit overindulgent” then you are totally not getting how important this time is. If you are thinking “it’s only relevant to rich people” then drop the champagne and the au-pair, but stick with bed and help from family. If you’re thinking “what if I’m a single mum” then think even harder about your postnatal care plan, because support matters, whether its from a husband, a mother, the NHS, a best friend or social services.

It’s my prediction that postnatal care plans will become more and more common. If you’ve ever used one, I’d love to hear from you.

Mia Scotland

Perinatal Clinical Psychologist

http://www.yourbirthright.co.uk

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

Blimey, I think I might be psychic……

December 15, 2013

ImageI have this dragging feeling in my chest. It kind of hurts, aches, pulls.  I have done yoga with a new teacher this morning, who tells me we were working on my solar plexus chakra, the green one. I wonder, as I’m stirring my tea, whether the dragging feeling is related to that. But it’s not that kind of ache.  Then I realise where I’ve felt it before.  What it is.  It is the ache I got when I had had my babies.  When my baby, waters, and placentas are gone, and the contents of my insides resettles themselves down again.  If I remember correctly, it only lasts a few hours, and it happens a few days after a birth. No one spoke about that feeling, so I don’t even know if it is normal.  But, eight years after my last baby was born, here it is again, in my chest.  Why?

The next day, I’m sat at the breakfast table.  I am talking to my husband about something mundane. It is Christmas party season, so it was probably something around that. And this well of tears forms in my eyes, and I just sit there and cry.  I don’t know why I’m crying. The tears just flow, out of nowhere, and it feels good.  It feels good, and bad at the same time.  It feels like I want to be picked up, be loved and looked after.  And I wonder why I feel like that?  And then I recognise this feeling.  It feels the same as day three baby blues.  And I realise, that it is day three since I left my most recent birth doula job. At first, I just remind myself to text her and see how she’s doing.  Then I remember how I felt the day before, with my chest.  And I wonder, am I feeling her feelings?  

And it seems obvious that I am.  But then my rational mind kicks in.  The one that was brought up in a skeptical, emotionally paralysed world, where science tells us its not possible to connect psychically with others, even though science knows that the world is made up of energy that we are only just realising how little we know about it. But I also remember back to my first pregnancy, when my husband experienced pregnancy symptoms and I didn’t. (Except for back ache.  It’s a real shame he didn’t get back ache!). And I remember the times I have sat with a woman in labour, feeling sympathy contractions.  I remember that only a few nights ago, I was woken with strong lower back sensations, and I thought to myself “she is going into labour”.  I remember how I used to know that my baby needed me, moments before he actually stirred. 

And I am torn two ways.  I am torn between the old and the new.  My old, black and white, pseudo-scientific way of reacting, and my new open minded, curious accepting, way of reacting.  The old part wants to question it, analyse it, work it out, talk to others about it, google it and blog about it (as you can see, it is creeping in here).  It is looking for answers, questioning and judging. But I don’t even have the words to use for the search engine! The new approach stays open to it.  Curious, but relaxed.  It doesn’t need to know.  It doesn’t need to question it and judge it.  It can just observe my excitement, and smile down at myself, like a mother watching her child discover snow for the first time.  This is a self-compassionate, meditative technique that I teach others in my work, to midwives, to hypnobirthing mums, and to anxious and depressed clients.  It’s good to find myself using it. And what is really lovely about this newer reaction, is that it will keep me open to new experiences.  I might find that I have more of these experiences that I can’t even find a name for.  Intuition?  Psychic connection?  Empathic resonance?  

I think I’ll just go onto my search engine and see if I can find the right word for it…….