Posts Tagged ‘post natal depression’

“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.

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.

Is it normal to be anxious when you have had a baby?

April 25, 2013

ImageThere’s an article about this going into Mother and Baby magazine soon.  They have asked me to comment. If a new mum was confiding in you, and telling you that she feels really anxious, what would you say to her to reassure her? 

Anxiety is normal after having a baby, don’t worry about it, or fight it.  It’s all part of the crazy but amazing journey that is motherhood. Lots is happening to you physically and emotionally, so it would be strange if you didn’t experience some anxiety along the way.

Physically :  your body has gone through childbirth, and continues to go through dramatic changes, as well as coping with disrupted sleep. It will take some time to adjust, and these adjustments can create anxiety.  Go easy on yourself and grab every opportunity to eat, drink, and rest.

Hormonally : When you have a baby, your levels of prolactin are high – especially if you are breastfeeding.  This is your “mothering” hormone, and is designed to make you more protective of your baby.  As well as making you more loving and putting your baby’s needs first, prolactin can also make you more snappy and anxious.  This anxiety is nature’s way of keeping  you on “look out” and making sure nothing happens to your baby.  It can make you feel like you are going a little crazy, but relax.  It’s only natural!

Emotionally:  You have suddenly taken on a twenty four hour job, with little sleep, no previous experience, and a huge amount of responsibility.  Of course you are more anxious.  Who wouldn’t be? Once again, go easy on yourself, and allow yourself to feel anxious or overwhelmed sometimes. 

Socially:  In some cultures, women are told to rest for 6 weeks after they have had a baby.  She doesn’t do any cooking, cleaning, or exercising.  All food is cooked for her, drinks are brought to her. In our society, it is very different. Women go home after they have had their baby, and are expected to carry on regardless.  The house still needs cleaning, visitors need cups of tea made for them, and you are expected to be up and about quickly, regain your shape, your social life, and your sex life, while looking after a little baby who needs all your time.  This adds pressure to women, and can make it a very anxious time.  Go easy on yourself, and accept every little bit of help that comes your way, or “buy” in help, in the form of a cleaner, a  post natal doula or whatever will take the burden off you.   

How to help yourself: Plan in advance, by getting as much support and help as possible, and ensuring that you have time and space to get used to being a mother.  This isn’t just about you any more, you aren’t resting and eating well for yourself, you are doing so for your baby.  In an airplane, you are told to sort out your own oxygen before helping your children with their oxygen.  It is the same when you are a mother.  Don’t feel guilty for prioritising your needs.  You have to take care of yourself, so that you can then take care of your baby.  A relaxed mum helps to create a relaxed baby. If your needs are to talk to friends, join mother and baby groups.  If your needs are to take a bath alone now and again, ask some-one to have the baby for half an hour.  If your needs are to have a clean house, get a cleaner.  Meet your needs as far as you possibly can. You are much more important now than you were before you had a baby. 

When to see your GP: Anxiety is normal, but it is worth seeking help if you, or some-one else, is worried about you.  If you think you are okay, but others tell you that you are not, then listen to them. Often, we don’t know how bad it is until we are recovered, so it is always worth just talking to some-one. If it is disrupting your life, it is also a good idea to talk to some-one about it.  For example, you are too anxious to leave the house, or you can’t let any-one else hold your baby, or if you are scared that you are going to hurt yourself or the baby, or you are cleaning the house obsessively, or it is affecting your relationships, then talk to your health visitor or GP.  There is nothing to be ashamed of, you are being responsible and taking care of yourself, and others are there to help.

What would you have added, if you had been asked to comment?  Please share.  Sharing always helps. 

Birth Trauma – Can it be fixed?

January 21, 2013

Image

The word “traumatised” has become like the word “starving” and the word “depressed”.  It has been watered down,  from something quite serious and potentially life threatening, to something we flippantly say when chatting about our experiences.  We might say “I am absolutely starving” instead of “I’m famished”.  We might say “I was so depressed” because our Christmas pressie turned out not to be the long awaited diamond ring.  And we might say “it was traumatic” when we mean “it was horrible”.  But we all know that to actually be starving means something very different.  And we might or might not know that to actually be depressed is a miserable state of being, a condition, not a fleeting  emotion.

So what about trauma?  If something was really scary and upsetting and horrible, were we traumatised?  Well, to a psychologist, trauma is as much about the aftermath of an experience, as it is about what actually happened. It is about how it leaves us feeling, long after the event.  It is not always about what actually happened, or even about how bad it was at the time. I’ve heard some birth stories that are so horrible, my insides are shrinking when I hear them.  But the mums are fine with it.  In fact, sometimes, the mums are remembering the experience fondly (I kid you not!  It must be the oxytocin).  I hear other birth stories that sound wonderful when described.  But the mums are sobbing with grief and horror while they tell me, even when the birth was years before.  How can that be?

Trauma is about the injury, not the event.  It’s like breaking a bone.  I might fall down a big flight of stairs, and walk away unscathed.  On the other hand, I might trip up over nothing, and break my ankle.  One cannot predict this, or control it.  The person who broke their ankle is not weaker or more stupid, and they cannot “pull themselves together”.

So when we are listening to a birth story, we don’t need to know about the event. We need to know about the reaction to the event. I want to know “can you talk about it without crying”.  I want to know “does it impact on your dreams”.  I want to know “do you try to shove it to the back of your mind, but you find it impossible”.  I want to know “what impact is it having on your life”.  I want to know “how long ago did it happen”.  If it is less than a few months, and the person is telling me about it, the chances are, she will be okay.  Usually, I’m hearing the story years later, because the person is pregnant again, and this flares up the previous trauma.

Is birth trauma treatable?

Yes.  I have been treating trauma for over 20 years, with an enormous amount of success.  It is treatable.  I promise you.  Time isn’t always enough. Some people go all their lives traumatised, until they receive treatment.  War veterans have suffered for decades with PTSD , until a short course of treatment lifts it.  And it can really feel like something has been lifted.  As one person once said to me “it was here – in my forehead – I couldn’t get rid of it – always there – always in my way.  It has gone.  I can’t believe it, it has totally gone”.    There are treatments out there that work.  We aren’t exactly sure what the treatments actually do, we just know they work.  They seem “move” the memory from the “I’m not safe” (threat activated) part of the brain, and lay the memory to rest in the “it was awful but it’s over” part of the brain.  While traumatised, the person feels as if it as just happened, and the body and brain are in a state of hyper-arousal.  This might involve nightmares, flashbacks, irritability, moodiness, tearfulness,  sleep problems , anger with your loved ones, constant memories of the incident, and efforts to push it out of your mind unsuccessfully.  If you are a new mother, it has even more consequences, because it interrupts the process of bonding with your baby.  Furthermore, the normal chaos that comes with adjusting to a new baby is heightened to create a potentially miserable cocktail.  Fathers can be traumatised by the birth too, but they often go under the radar, so we know very little about this. Mothers have been going under the radar for a long time, because many cases of PTSD were misdiagnosed as post natal depression.  We are only just beginning to realise how common post natal depression is in fathers (almost equal to mothers, in some studies) and the fact that this might be related to birth trauma in fathers.

In our society, we are led to believe that we should be able to control our emotions, but if we have been traumatised for 6 months or more, then trying to control it may exacerbate the problem. This is because, with PTSD, the more we try to “control” the emotions (in other words, the more we try to push the memory to the back of our minds), the more the problem anchors itself in the brain, because you are preventing the brain from processing  the event properly.  This is where therapy can help.  Therapy enables the brain to change the memory, so that it becomes processed into the “history” part of the brain rather than the “I’m not safe” part of the brain.  Before that, the memory seems to be stuck in the “oh my god I’m not safe and this is awful” part of the brain, leaving the person with “symptoms” as outlined above.

There are many effective therapies out there. I’ve tried a few of them. I now mostly use the rewind technique (a hypnotic technique, taught to me by the Human Givens Institute) which seems to be the most effective, the quickest, and the least distressing.   It can be one session.

I am now teaching this fast, fairly painless and effective technique to professionals who find that they want to help parents let go of the horror of a difficult birth. It’s a two day course which gets great feedback. It gets great feedback on the day, but also great feedback when people start applying the technique. There really is nothing better than knowing that you have made a dramatic difference to some-one’s life. To find out more about the upcoming training workshops, go to http://www.traumaticbirthrecovery.com/courses-for-professionals/

Mia Scotland

Clinical Psychologist

http://www.yourbirthright.co.uk