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Miscarriage & Infertility Therapy

Miscarriage and Infertility Therapy - AZRI - Arizona Relationship Institute Mesa Gilbert JPG

 

Miscarriage & Infertility Therapy
By Kristin Edling

Miscarriage and Infertility, just those few words are impactful and bring about individual thoughts, emotions, and beliefs.  They can be downplayed or dismissed; however they should be considered as traumatic events. Similarly to other forms of traumatic events each person who experiences a Miscarriage or Infertility are impacted differently.

Mental Health Concerns Associated With Infertility and Miscarriage - Mesa AZ - Arizona Relationship Institute

Mental Health Concerns Associated With Infertility and Miscarriage

Many women report that they have symptoms that are consistent with Post Traumatic Stress Disorder, which is more commonly known as PTSD.  Yes, that is correct the same PTSD diagnosis that soldiers who experience wartime are diagnosed with.  With those PTSD symptoms being experienced by many women after a miscarriage or while experiencing infertility there is often a glazing over regarding the mental health treatment by both the physical and psychological health fields as well as society on a macro level.  Over 40% of women experience PTSD symptoms following their miscarriage.

Miscarriage Infertility and Post-Traumatic Stress Disorder PTSD - AZRI - Arizona Relationship Institute Mesa Gilbert JPG

Miscarriage, Infertility, and Post-Traumatic Stress Disorder (PTSD)

Many of those symptoms of PTSD that are experienced are reexperiencing feelings of loss, an attempt or actual avoidance of situations or experiences that are a reminder of their loss, nightmares, or flashbacks.  Often as a rule of thumb to avoid something that is activating of PTSD symptoms avoiding people, places and situations that bring on those symptoms.  Approximately half of women report that they have ongoing anxiety and depressive symptoms for about four months following a miscarriage.  In terms of grief, women that experience a miscarriage experience grief that is characterized as a major traumatic loss that is sudden and unexpected.

The physical healthcare field has a gap in any form of follow up appointments to ensure physical healing and recovery.  After experiencing a miscarriage, regardless of the gestational period, would allow for space to screen for depressive and trauma symptoms postnatal.

Shame and Postnatal Mental Health Therapy in Arizona - AZRI - The Arizona Relationship Institute

Shame and Postnatal Mental Health

The mental health field tends to not allow the therapeutic intervention as to many think it is a space of shame and minimizing the mental health ramifications.  This shame often begins with what a pregnant woman “SHOULD” or “SHOULD NOT” be doing during pregnancy.  Now granted many of those are medical recommendations and that is not the premise for shame.  Shame is built on the stigmatization that a woman should have her pregnancy secretly until she has cleared 12 weeks of gestation.  This is not beneficial to trying to avoid postnatal depression and Post Traumatic Stress Disorder symptoms.  Healing begins when a person is seen, heard, and validated.  When a pregnancy must be kept silent and hidden that can prevent being seen, heard, and validated, especially by those who are the most supportive and closest to us.  This shame cycle can have prolonged and potentially lifelong psychological effects.

Therapy and Support for Infertility and Miscarriage - Mental Health Therapists in Mesa AZ

Therapy and Support for Infertility and Miscarriage

Research that was conducted and concluded in 2013 by the World Health Organization highlighted that there is not a standardized format of psychological support following a miscarriage or throughout Infertility. Identifying distressing symptoms and the development of mental health problems in follow up appointments can be key to potentially future healthy pregnancies.  This was noted through the research in 2010 that women that experienced a miscarriage, even when they had a living child, would experience an increased rate of anxiety and distress that is specific to pregnancy.

Therapist for Trauma and Reproductive Issues in Arizona - AZRI - The Arizona Relationship Institute

Therapist for Trauma and Reproductive Issues

As a therapist that works with trauma and reproduction, it is imperative that the Mental Health community begins to recognize and assist in the healing process of those who are experiencing infertility or a miscarriage.  The Mental Health community can help by utilizing the language of Reproductive Trauma.  This can begin the healing process, as the verbiage of Reproductive Trauma allows people to be seen, heard, and validated.  Being seen, heard, and validated is the basis for where all healing begins, so having the recognition that your miscarriage and infertility is seen, heard, and validated.

If you are reading this and have experienced a Miscarriage or Infertility let’s take a moment to acknowledge:

      1. Your mind remembers
      2. Your body remembers
      3. You carry these experiences with you

Your mind remembers the feeling of a positive or negative pregnancy test, the anticipated due date, the feeling of injections, the extensive testing to determine what the cause could be, the cost associated with the appointments, the sound of the doctor’s voice telling you that you’re pregnant or have had a ‘failed’ cycle, the anticipated due date.

Your body remembers the coldness of a speculum or exam table, the early waking for appointments, the pain, the contractions.

You carry this with you in the form of the calendar as the biggest reminder or trigger point.  When should our next doctor’s appointment have been?  The birthdays. The anniversaries.  Then there are the questions and the hopes and dreams about your Reproductive Story.

Therapy for Infertility and Miscarrige in Arizona - AZRI - The Arizona Relationship Institute

Being seen, heard, and validated be important to the healing process is because we all have a Reproductive Story.  As children, many of us have played house and assumed the role of the Mommy or the Daddy, we had imaginary children and cared for them through our play.  This play can begin as early as about 18 months old and can continue through childhood.  As adolescents or young adults dating and looking for a potential future spouse there is often a conversation of whether or not each person wants children and how many children they would want as a couple.  Then fast forward to we have found our person we want to have children with and take a step, such as engagement or marriage, the commonly asked question is asking when you will have a baby.

Reproductive Trauma Therapy and Counseling - AZRI - Arizona Relationship Institute Mesa Gilbert JPG

Reproductive Trauma, Therapy, and Counseling

All of this to be said, we all have a fundamental thought process of what we presume our Reproductive Story will be.  So, when there is an alteration to the plan, such as Infertility or Miscarriages, there is often a feeling of bodily betrayal and betrayal of our Reproductive Story.  Body Betrayal is when our body feels as if it is a traitor that has betrayed our mind.  This betrayal needs to be resolved as it is deeply engrained within the trauma symptomology.

An example of this is you are one day late of your anticipated menstruation, and you get your period or you’re pregnant and begin spotting.  These are triggering events to the Depression and Post Traumatic Stress Disorder that many experience in conjunction with Reproductive Trauma.  Through therapy we can begin to heal your Reproductive Trauma.15 Minute Consult CTA Image

 

Parenting Through Trauma Informed Glasses

Parenting Through Trauma Informed Glasses - The Arizona Relationship Institute - AZRI

 

Parenting Through Trauma Informed Glasses
By Kristin Edling, MA, MFT, BHT

Every person needs to come from a home that has a foundation in love and safety.  This is especially true for children that have experienced traumatic events, such as abuse and neglect.  Parenting as a human experience presents with its own set of challenges, victories, and struggles, however parenting through and after a child has experience trauma requires a special parenting skill set.  Parenting through a Trauma Informed Lens impacts that way each parent or caregiver views the world of their child.

Trauma-Informed Parenting in Arizona - Family Therapists in Mesa AZ - AZRI

Trauma-Informed Parenting

In order to achieve a Parenting Trauma Informed skill set the first thing is to be aware of the various forms of trauma and how they can impact the child as well as the family as a whole.  An event or experience is considered to be traumatic if there is a threat to the safety of the child or a perceived threat to their safety.  The most commonly reported forms of trauma are Neglect, violence, accidents, life events, world events and loss.

Each child will experience and respond to traumatic stress in their own unique way.  This reaction for reach of child can be dependent on previous life experiences, such as how someone in authority has responded in support or anger towards that child in the past, as well as that child’s individual developmental level.  These responses tend to interfere with the child’s functioning abilities within their daily life and their relationships with others.

Signs of Traumatic Stress in Children:

Preschool Aged Children

    •  Fear of Parent/Caregiver separation
    • Weight loss
    • Poor eating/drinking capabilities and habits
    • Frequent crying
    • Frequent screaming
    • Nightmares 

Preschool Aged Children

    •  Suddenly becoming anxious or fearful
    • Feeling guilt
    • Feeling shame
    • Difficulty sleeping
    • Difficulty Concentrating

Preschool Aged Children

    • Feelings of loneliness 
    • Feelings of being Depressed 
    • Formation of self harming behaviors, including Eating Disorders 
    • Substance Abuse 
    • Hypersexuality

Long Term Effects

    • Learning difficulties
    • Suspensions
    • Expulsions
    • Increased need for lifelong Mental Health Services
    • Increased physical health problems
    • Chronic Substance Use/Substance Abuse
    • Increased involvement in Foster Care
    • Increased involvement in Juvenile Justice System/Criminal Justice System

Trauma Informed Parent Glasses – How You See Your Child

At times being a Parent seems as there are so many hats that you have to wear on a daily basis and being a Trauma Informed Parent creates glasses for you instead of a hat as it changes the way you view your child.

Your child’s brain develops and matures from back to front, with the most vital functions such as automatically breathing, heart beating and caregiver awareness being some of the first.  Logic and reasoning are some of the last developing functions of the Brain.  Which makes the human experience of being a parent a unique one.  Through our development and various experiences our brain creates blueprints based on our interactions and experiences in order to try and ensure our survival.  Surviving on a biological level is the goal and purpose of creating and maintaining these blueprints.

Dealing with Fear and Anxiety in Children - Family Therapy Arizona - AZRI

Dealing with Fear and Anxiety in Children

When a scary event, such as a traumatic event or experience occurs the brain wants to ensure the brain and the body remembers what happened and how that individual reacted in order to ensure that they survived.  So the brain believes it has done a its job in ensuring the body survived the traumatic event and then it takes that information and creates a blueprint through a repetitive process of copy and paste to ensure that it is not forgotten.

The Brain will also include the sensations of the traumatic event, such as what may have been experienced through smell, physical sensations, taste, sound and then couples it with the emotions of extreme fear and blends them together with the memory.  This can create an experience that the child is reliving the traumatic event and experience on an ongoing basis or when a sensation is experienced without the traumatic event.

Rather than being able to utilize logic and reasoning, the Brain uses its previous blueprints to react in their current experiences.  This reaction is often referred to as being “triggered”.  However, that phrase has been generalized in recent years and is intended to mean that the traumatic event of the past is causing the child to demonstrate behaviors in the present.  Rather viewing the sensations that are bringing about behaviors in the present that were used by the brain during other times of traumatic stress, is Activating.  Utilizing the term of Activating or an Activation is centered around the Brain, the Nervous System and the body as a whole.  It is important to note that the child is not ‘being bad’ or ‘misbehaving’, rather the child is reacting just like their biology has been programmed to.

In addition to the Brian’s copy and paste capability, the Nervous System also utilizes the Fight, Flight, Fawn, and Freeze responses as a means of surviving traumatic stress.  These responses are drawn out of a child who has felt a sense of helplessness generating the body’s protective mechanisms to spring into action.  As we review these bodily reactions it is important to remember that these responses are considered to be automatic on an instinctual level with the goal of to survive the danger that the person is being faced with.

Traumatic Stress Responses in Children and Adults

Traumatic Stress Responses in Children and Adults

Fight: Fight is the bodily response that is activated through an adrenaline surge to prepare the body to confront a threat that is real or perceived.  The Fight response can manifest in forms of being confrontational, argumentative, verbal and/or physical aggression.  A child reacting in a Fight response is a means of trying to empower themselves after an event or experience where the child had a sense of a lack of control.

Flight Flight is considered to be on the other end of the Activation spectrum as it is a means of removing oneself from the real or perceived danger.  During Flight the behaviors are consistent with trying to avoid people, places and situations in creating emotional and physical distance between the child and the event.  A common generalized scenario would be if someone yells ‘Fire”, the automatic response is often one of flight, run to the exit and get out of there.

Freeze:  Freeze is a common response to being too overwhelmed to escape from real or perceived danger.  Freeze is a state of being emotionally and/or physically immobilized in such a way that there is a state of numbness, paralysis or even dissociation.  A common generalized example would be an animal that plays dead in the presence of a predator just hoping that they threat will move on.

Fawn Fawn is a response that can often be seen in children that have been neglected and ‘parent-ified’.  This is characterized by a sense of people pleasing and wanting to be helpful and agreeable in order to avoid a perceived or real threat.  A Fawn response often emerges from the need for perceived safety and connection regardless of the child’s individual needs and boundaries.  An example of a Fawn response as a parent is imagine you show up to school and are told by your child’s teacher that there is a bake sale tomorrow and you need to bake 100 cookies by tomorrow morning.  The Fawn response would be to pretend to be excited and able to do that in an effort to make sure there is connectedness between you and the teacher and other parents in the classroom.

It is important to remember that the body can present with one or more of these reactions and they are instinctual, meaning they are not the child’s choice to have them.  As a parent you can decrease a child’s reactions by creating and maintaining a safe environment that is consistent, loving and empathetic to foster healing and health.

What To Do When Your Child Confides In You About Abuse or Neglect - AZRI

What To Do When Your Child Confides In You About Abuse or Neglect

Anchor Yourself As a Parent

As a Parent, if your child confides the abuse or neglect that has been experienced maintaining our own regulation can be like we are fighting our own biological responses.  More often than not there is a reaction, which can be counterintuitive to healing, so trying to anchor yourself to the present moment can be helpful.  This anchoring or grounding can be done by orientating yourself to the present moment through sitting and being aware of the feeling of the chair underneath you, removing your shoes and experiences the sensations of the ground beneath your feet or taking a sip of a cold beverage.  It is also completely understandable to need to take a moment to collect your thoughts and emotions regarding what has been disclosed.

Following your child’s disclosure give yourself permission to step away.  Ensure that you express that your child is safe and that you’re going to make sure that they stay that way.  Many of us going into a state of being fact finders, understandably wanting to know everything in the moment which can create a new blueprint for your child of not feeling seen, heard and validated.  In the world of Trauma Therapy, we say that healing begins when our experience has been seen/heard and validated by another.  So rather than going to a place of interrogating them about the details, express that you are going to make sure that the child is safe.  Being patient and allowing grace for yourself and your child is a step in the direction of healing.

Tips For Dealing with Trauma in Children

As a Trauma Informed Parent understanding how your child’s brain and body are reacting following a traumatic event creates a perspective that avoids the questions most parents ask themselves about or to their children, such as ‘why are you doing this?’ Instead with a Trauma Informed Parenting Lens you are able to ask yourself “what is happening for my child in right now at this exact time?’ And ‘how can I be my child’s safe person’.  In having an awareness about these specific questions there are three vital components of helping your child heal at home as a Parent and they are:

  1. Safety – Be the safest person in your child’s life.  Be present in a nonjudgmental manner.  Be open to listening and reinforcing their boundaries and their voice of their needs.  For example, if there is a family member at the family party insisting that your child gives them a kiss goodbye and the child is resisting, running away or even verbalizes no as the Parent being able to reinforce your child’s boundary to that family member so that your maintaining what feels safe for your child in that moment.
  2. Love – Show them that they are loveable, loved and reinforce what a loving relationship should feel like. A way that we can show a child that he or she is loveable is through modeling.  Modeling is when we show our child how to do it before they can do it themselves.  For example, not body shaming yourself.  When going to buy clothes for yourself with your child avoid statements such as ‘this makes me look fat’.  Rather statement such as ‘this isn’t the best for my body’, can prevent feelings of shame and being unlovable.
  3. Regulation A Dysregulated Adult Will Never Regulate a Dysregulated Child… say that again and again to yourself.  When as child is reacting through their behaviors, such as a tantrum, it is important for the parent to be as calm as humanly possible.  That child’s brain and body is in need of being calmed, regulated, on a brain and nervous system level.  A calm voice coupled with calm mannerisms can assist the parent in calming the child and reinforcing love and safety.

Parenting Tips For Tantrums - Arizona Parenting Therapy and Family Therapy - AZRI

Parenting Tips For Tantrums

After the behaviors have resolved and the child has been regulated it can be beneficial for the Parent to review the incident.  For an example of a tantrum, a parent can review the indecent through the ABC’s of Behavior.  A is for Antecedent, what happens just before the behaviors occurred.  B is for Behaviors, what behaviors was my child displaying and how do those behaviors serve them in that moment.  For C is the Consequences, what are the natural consequences that the child experiences as a result of their behaviors.  It is important to note that Consequences does not equate to Punishment.

Sharing Control & Choice Theory - Parenting Therapy and Advice For Parents in Arizona

Sharing Control & Choice Theory

Additional strategies for creating a relationship and environment of healing and health for your child is through sharing control with your child when possible.  Sharing control, or Choice Theory, can seem counterintuitive to how you were raised by your parents, but you are growing in your Trauma Informed Parenting which means trying new things even if they are safely uncomfortable.  This model of shared control can be perceived control or actual control.

Perceived control creates the perception that the child is in control of the outcome of their choice.  Actual control puts the child in the driver seat completely.  Regardless, of whether or not the control is perceived or actual, by giving your child a sense of control through simple choices there is a sense of safety and empowerment.  The subtle message that begins to become your child’s blueprint is that I have a voice and my choice matters.  It also creates a blueprint that I can say no and it will be listened to.  It is important that you as the parent are agreeable to either choice that the child makes and that you respect the child’s decision.

An example of this is would be ‘are you going to put your shoes on or would you like me to help you put your shoes one?’, either way the child is making a choice where their shoes are going on.

Parenting Therapy and Child Trauma Counseling in Arizona - Arizona Relationship Institute

Consistency Is  Key In Parenting

As mentioned before, consistency in your parenting actions as well as with routine can be helpful.  A way to integrate consistency with your schedule, especially in a busy world, can be really difficult to achieve and maintain.  An example of consistency that you can implement is by if your child is going to therapy for their traumatic stress, on therapy days the same dinner is had.  This helps to decreases feelings of anxiety and create or reinforce a sense of safety.

Parenting as an experience can be quite the journey and each of us are learning along the way, so give yourself some grace in knowing that you are doing the very best you can in this very moment.  Parenting with a Trauma Informed Lens also means modeling self love.