Many of the women I know are trying very hard to deal with the emotional fall out from a traumatic birth. Our external culture is no help at all since as mothers, we are supposed to be so ecstatic with the birth of a child that nothing else matters (because all that matters is a healthy baby, right?) and if we are upset or depressed, its just “postpartum depression”, the result of raging hormones and lack of sleep, and will resolve with time and a bit of medication. I’m starting to believe that the “postpartum depression” that I see so much of isn’t at all postpartum depression – its post surgical depression (a known complication of any surgery except cesarean surgery) complicated by postpartum issues. When you add clinical depression to the physical shifts after birth to the often dramatic changes in things like career, marriage and self-image that naturally occur when a baby joins a family, you have a recipe for one of the most devastating emotional periods of a woman’s life.
It seems to me that there are basically 3 ways that people deal with emotions. The first is the “stuff it” method – if an emotion is unpleasant or uncomfortable or confusing, just pretend like you aren’t feeling it. Act like nothing is wrong. Fake it till you make it. This is a pretty common response, certainly its one that our society encourages. I know that I come from a family of really adept stuffers so it isn’t a surprise that I naturally resort to denying my feelings. The second is the “defining emotion” method – this is where any given emotion at any given time defines your life. Life is a series of dramatic highs and lows; whatever you are feeling at that moment is who you are. People like this are often embarrassing to stuffers and are described with words like “volatile” and “out of control”. The third way is actually a method that gets used when you realize you are a stuffer or definer and you realize that neither of those methods is healthy – it’s the intellectualization of feelings. It’s the idea that if you just figure out why you are feeling the way you are, you can then not feel that way anymore. The premise is that unpleasant feelings can be explained away if you just dissect them into their component parts. A lot of people do this – I know that I do, since I know that stuffing my feelings isn’t a healthy thing to do.
The problem is that none of these things work. You can’t stuff feelings – they will show themselves one way or another – it might be with a blow-up after some minor event, it might be with something like persistent depression, it might be with physical pain or other problems. I believe that our physical bodies and our minds/emotions are not isolated from each other and that there is a lot of communication back and forth that we aren’t even aware of on a conscious level. At any rate, feelings will not stay tidily stuffed. Letting feelings rule us doesn’t work either. It leaves you controlled by something that is by definition not rational. It’s like being held captive by a toddler – tossed here and there without any hope of a more controlled response to the world around us. It denies the rational part of ourselves – and it’s just as bad to do that as it is to deny the non-rational part of us. Intellectualizing is the most difficult to let go of – because it does seem to work in the short term. The problem here is that feelings aren’t intellectual. You can understand why you have a particular emotional response to something but it’s unlikely that you’ll stop having the response. Oh, you might be able to then “distance” yourself from the response and feel like you have some control over it, this might keep someone from reacting emotionally when they don’t want to – but its really just a fancier way of stuffing – the emotion itself hasn’t been acknowledged in any meaningful way and certainly, the importance of the emotion isn’t acknowledged.
So what to do? Well first, why do we have emotions at all? The happy ones are nice, but what purpose do they serve? And wouldn’t it be great if we didn’t have to worry about negative emotions – about feeling scared, or angry, or sad, or ashamed. Emotions aren’t just the trimming that comes with being human – they tell us very important things about ourselves and our world – both internal and external but they don’t use our rational intellect to do it. That doesn’t mean that our rational intellect has to be put aside, what I’m learning is that it means we need to learn how to integrate our emotional intellect with our rational intellect. When that happens, we are more whole than we can imagine.
Ok, before I get into the actual details of what I’m learning to do, I’ll give credit where credit is due – I didn’t figure any of this out myself. Much of it has come from my counselor – he recognized early on that this was an area that I (and my husband) desperately needed help in. And recently, he’s had us reading a book called “The Pathway” by Laurel Mellin. It’s an interesting book – rather infomercial-ish at times, because the author is definitely promoting an organized method with resources and groups and training, but in it is some good stuff that is simple and practical. Which is critical because when you do realize that you’ve got to stop stuffing, or reacting or intellectualizing, you can’t “just stop”. You have to replace what you do with something else. That’s what this has done for me. I’m not very good at it yet but when I do remember, it makes a big difference. The only thing I’ve done that’s even a little original is change some of the language and distill it down to something that’s easy for me to remember. Because practice is vital – none of this will help at all unless its done over and over and over…and hopefully becomes automatic at some point, which then means the old unhealthy ways of dealing with emotions really are no longer in control.
So, what do I do? Let’s say I’m feeling really crappy about something – someone has said something or there’s a situation at work or at home that has me upset. My old response (and unfortunately too often my response still) would have been to try to figure out why I was feeling the way I was and then by the power of my intellect, not feel that way anymore, since I would have “explained” the whole situation away. Instead, if I do the following, I find that I actually do feel better.
First, I just stop and feel the feeling. I try to do it without thinking about what I’m feeling. I just let the feeling happen – it’s sort of like letting a wave go ahead and wash over you, knowing that you’ll go under but also knowing that you’ll come up again after the wave passes. There’s something about just letting the fear or anger or grief or shame rise up that then takes some of the power out of it – and it gives me more strength to then work with since I’m not fighting the feeling anymore. I acknowledge that I’m feeling something, without worrying about why. I just feel it. Now, for an accomplished stuffer, this can be really really scary – what if you lose control? Well, I don’t recommend doing this in an unsafe place, especially if the feeling is something really deep and strong – and I’ve been taught that it’s important to be very specific – don’t just “feel depressed”, try to be specific and situational – “I’m angry right now”, “I’m anxious right now”, “I’m sad right now”. Anyway, what sort of loss of control are we so scared of? That we might cry? Or even weep “uncontrollably” (I don’t think anyone has ever wept so hard that they never stopped, though I’m sure it has felt that way in the midst of the weeping). That we might commit some act of violence in our anger? Unlikely for most of us, I think. Any way, you HAVE to feel what you are feeling. After all, you are already feeling it…and you aren’t going to stop it by pretending it isn’t happening.
Then I make a series of statements. Often I go through the list several times, because as I do, more things become clear to me. It really helps me to say this stuff out loud – the book would recommend finding a person to listen to you while you do it – I haven’t done that yet but I do know it is more helpful if I actually say this stuff out loud.
I am afraid that/because _______________
I am angry that/because ________________
I am sad that/because _________________
I am ashamed that /because ____________
After I’ve gone through these statements as many times as it takes to not have any new answers, I ask myself the following questions.
What is my unrealistic expectation in this situation? When we are upset, it’s because we have some expectation that isn’t being met or that we don’t think will be met – it’s important to figure out what that expectation is.
What would be a realistic expectation? This always exists – it might not be what we want but there’s always a realistic expectation to any situation.
Once I’ve figured out what I expect and what I can reasonably expect, then I ask myself these questions.
What in this situation is part of living in a broken world – where stuff happens that isn’t good or fair, where people behave in ways that aren’t kind or correct – stuff that I can’t do anything about, even though it hurts me. What is the hurt in this situation that I simply can’t avoid?
What is the positive thing that I’ll gain or learn or become when I handle this situation in a healthy manner? What is the good I’ll take away from this, even though it might not be what I wanted or expected? There is always something – and it’s important to find it. It’s not always or even usually life altering – but it’s always there.
Now, ideally, we’d be doing this from childhood, because it would be modeled to us and it would be almost instinctive and it wouldn’t seem so contrived. I’m told that if you do this sequence often enough, it will become habit – you won’t really have to ask these questions so specifically – I’m not anywhere near that but I do hope to be someday. And probably as importantly to me, I hope to teach this to my children now so that they do have a chance of using it instinctively. I think that would be an amazing gift to give them.
So, let’s do this with a real situation. Since a lot of the emotional pain I see is related to birth trauma, I’ll work out something related to the pain I experience during my work with other women.
Sometimes a woman comes to the ICAN list requesting support planning a VBAC. She’ll explain her situation and then responses will come – some just welcomes, some questions, some challenging things she might have said, assumptions she has, fears she has expressed. And sometimes, this woman will listen and sometimes she won’t. When she doesn’t, if she stays on the list, what often happen is she has another cesarean. Usually she has some reason why it was “necessary”, often looking very “unnecessary” to some of us.
When this happens, I am often angry. My fingers type harder on the keyboard, my heart beat increases, I snap at my children and my husband. It can make the rest of my day very unpleasant for me and those who have to live with me.
So, I sit quietly and I let myself be angry. I feel the anger rise up and consume me. Then it recedes. It isn’t gone but it is quieter. And I’m ready to start asking myself some questions.
I’m angry because another woman got cut.
I'm angry because she was lied to again.
I’m angry because she believes she is broken
I’m angry because she didn’t listen to us.
I’m angry because she trusted her caregiver and they manipulated her.
I’m sad because she has to recover from surgery.
I’m sad because she’s probably going to be sad soon and that will make things harder.
I’m sad because now it will be even harder for her, if she has another baby.
I’m afraid that I’m not making a difference in something so important to me.
I’m afraid she’ll be really depressed.
I’m afraid we didn’t say or do something that we should have, that would have made the difference.
I’m ashamed that I am angry at this woman.
I’m ashamed that sometimes I want to give up.
I’m afraid that she’ll never realize what happened to her
I’m afraid that she will realize what happened and will be devastated.
I’m afraid of the process that will unfold if she stays and starts to ask hard questions about what happened to her.
I’m afraid that she’ll pass on the idea that she’s broken to her children, especially her daughters.
I’m afraid she’ll tell people that we are crazy, since it didn’t work for her.
I’m afraid other women will be discouraged because of this.
I’m ashamed that I second guess what happened.
What was my unrealistic expectation?
That this woman would listen to us and make the changes we recommended and would then be guaranteed a VBAC and since she didn’t, I know what happened and why.
What is the realistic expectation?
Some women will listen and have a VBAC, some women will not listen and have a VBAC, others will listen and have repeat cesareans, and others will not listen and have repeat cesareans. I can make a difference and I do make a difference but it is always more than just me and what I know. All I can do is give her tools to stack the odds in favor of a VBAC. Ultimately, it is her responsibility, not mine.
What is the unavoidable pain?
If I am going to doing this, some women will not listen to me and will have a very predictable outcome, and sometimes, it will be because they didn’t listen. I can’t “save” them all. And sometimes, women listen and change plans and still end up with a cesarean, so I really can’t “save” anyone.
What do I take away from this?
Renewed humility knowing that I’m just a small part of things, always a good thing to be sure of. Relief that it isn’t my responsibility, that I’m not responsible for the choices someone else makes. Renewed determination to make a difference where I can. Willingness to be angry or sad because it’s ok to feel those things when injustice or just bad luck happens and it means that I really do care. Realizing that I’m not burned out or becoming apathetic.
I did that exercise straight through, so it’s probably pretty representative of the actual process. No real editing was done J . Anyway, I’ve yet to find a situation where I couldn’t do this – not that I remember most of the time, but when I do, it helps a lot. I haven’t denied how I’m feeling, I have worked on understanding what I’m feeling and I’ve looked at why I have the feelings I do and then I’ve given myself a more realistic look at the situation. I’m still freely feeling but its not controlling me and I’m not pretending it isn’t there. I’ve integrated it with my intellectual self and because of that; I understand myself and the situation better than before.
Hope this didn’t sound too out there – I’m sure I sound a bit the new convert – I guess maybe I am – it’s just hard to not share something that has made such an impact on my entire life. And if this can in any way help someone to find their way out of emotions that seem overwhelming, then I guess its ok to look a bit silly.