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 ďpostpartum depressionĒ, the result of raging hormones and lack of sleep, and will resolve with time and a bit of medication. Iím starting to believe that the ďpostpartum depressionĒ that I see so much of isnít at all postpartum depression Ė 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 womanís life.
It seems to me that there are basically 3 ways that people deal with emotions. The first is the ďstuff itĒ method Ė if an emotion is unpleasant or uncomfortable or confusing, just pretend like you arenít 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 isnít a surprise that I naturally resort to denying my feelings. The second is the ďdefining emotionĒ method Ė 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 ďvolatileĒ and ďout of controlĒ. 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 Ė itís the intellectualization of feelings. Itís 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 Ė I know that I do, since I know that stuffing my feelings isnít a healthy thing to do.
The problem is that none of these things work. You canít stuff feelings Ė they will show themselves one way or another Ė 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 arenít even aware of on a conscious level. At any rate, feelings will not stay tidily stuffed. Letting feelings rule us doesnít work either. It leaves you controlled by something that is by definition not rational. Itís like being held captive by a toddler Ė tossed here and there without any hope of a more controlled response to the world around us. It denies the rational part of ourselves Ė and itís 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 Ė because it does seem to work in the short term. The problem here is that feelings arenít intellectual. You can understand why you have a particular emotional response to something but itís unlikely that youíll stop having the response. Oh, you might be able to then ďdistanceĒ yourself from the response and feel like you have some control over it, this might keep someone from reacting emotionally when they donít want to Ė but its really just a fancier way of stuffing Ė the emotion itself hasnít been acknowledged in any meaningful way and certainly, the importance of the emotion isnít 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 wouldnít it be great if we didnít have to worry about negative emotions Ė about feeling scared, or angry, or sad, or ashamed. Emotions arenít just the trimming that comes with being human Ė they tell us very important things about ourselves and our world Ė both internal and external but they donít use our rational intellect to do it. That doesnít mean that our rational intellect has to be put aside, what Iím 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 Iím learning to do, Iíll give credit where credit is due Ė I didnít figure any of this out myself. Much of it has come from my counselor Ė he recognized early on that this was an area that I (and my husband) desperately needed help in. And recently, heís had us reading a book called ďThe PathwayĒ by Laurel Mellin. Itís an interesting book Ė 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 youíve got to stop stuffing, or reacting or intellectualizing, you canít ďjust stopĒ. You have to replace what you do with something else. Thatís what this has done for me. Iím not very good at it yet but when I do remember, it makes a big difference. The only thing Iíve done thatís even a little original is change some of the language and distill it down to something thatís easy for me to remember. Because practice is vital Ė none of this will help at all unless its done over and over and overÖand 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? Letís say Iím feeling really crappy about something Ė someone has said something or thereís 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 ďexplainedĒ 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 Iím feeling. I just let the feeling happen Ė itís sort of like letting a wave go ahead and wash over you, knowing that youíll go under but also knowing that youíll come up again after the wave passes. Thereís something about just letting the fear or anger or grief or shame rise up that then takes some of the power out of it Ė and it gives me more strength to then work with since Iím not fighting the feeling anymore. I acknowledge that Iím feeling something, without worrying about why. I just feel it. Now, for an accomplished stuffer, this can be really really scary Ė what if you lose control? Well, I donít recommend doing this in an unsafe place, especially if the feeling is something really deep and strong Ė and Iíve been taught that itís important to be very specific Ė donít just ďfeel depressedĒ, try to be specific and situational Ė ďIím angry right nowĒ, ďIím anxious right nowĒ, ďIím sad right nowĒ. Anyway, what sort of loss of control are we so scared of? That we might cry? Or even weep ďuncontrollablyĒ (I donít think anyone has ever wept so hard that they never stopped, though Iím 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 itÖand you arenít going to stop it by pretending it isnít 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 Ė the book would recommend finding a person to listen to you while you do it Ė I havenít 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 Iíve 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, itís because we have some expectation that isnít being met or that we donít think will be met Ė itís important to figure out what that expectation is.
What would be a realistic expectation? This always exists Ė it might not be what we want but thereís always a realistic expectation to any situation.
Once Iíve 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 Ė where stuff happens that isnít good or fair, where people behave in ways that arenít kind or correct Ė stuff that I canít do anything about, even though it hurts me. What is the hurt in this situation that I simply canít avoid?
What is the positive thing that Iíll gain or learn or become when I handle this situation in a healthy manner? What is the good Iíll take away from this, even though it might not be what I wanted or expected? There is always something Ė and itís important to find it. Itís not always or even usually life altering Ė but itís always there.
Now, ideally, weíd be doing this from childhood, because it would be modeled to us and it would be almost instinctive and it wouldnít seem so contrived. Iím told that if you do this sequence often enough, it will become habit Ė you wonít really have to ask these questions so specifically Ė Iím 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, letís do this with a real situation. Since a lot of the emotional pain I see is related to birth trauma, Iíll 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. Sheíll explain her situation and then responses will come Ė 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 wonít. When she doesnít, if she stays on the list, what often happen is she has another cesarean. Usually she has some reason why it was ďnecessaryĒ, often looking very ďunnecessaryĒ 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 isnít gone but it is quieter. And Iím ready to start asking myself some questions.
Iím angry because another woman got cut.
I'm angry because she was lied to again.
Iím angry because she believes she is broken
Iím angry because she didnít listen to us.
Iím angry because she trusted her caregiver and they manipulated her.
Iím sad because she has to recover from surgery.
Iím sad because sheís probably going to be sad soon and that will make things harder.
Iím sad because now it will be even harder for her, if she has another baby.
Iím afraid that Iím not making a difference in something so important to me.
Iím afraid sheíll be really depressed.
Iím afraid we didnít say or do something that we should have, that would have made the difference.
Iím ashamed that I am angry at this woman.
Iím ashamed that sometimes I want to give up.
Iím afraid that sheíll never realize what happened to her
Iím afraid that she will realize what happened and will be devastated.
Iím afraid of the process that will unfold if she stays and starts to ask hard questions about what happened to her.
Iím afraid that sheíll pass on the idea that sheís broken to her children, especially her daughters.
Iím afraid sheíll tell people that we are crazy, since it didnít work for her.
Iím afraid other women will be discouraged because of this.
Iím 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 didnít, 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 didnít listen. I canít ďsaveĒ them all. And sometimes, women listen and change plans and still end up with a cesarean, so I really canít ďsaveĒ anyone.
What do I take away from this?
Renewed humility knowing that Iím just a small part of things, always a good thing to be sure of. Relief that it isnít my responsibility, that Iím not responsible for the choices someone else makes. Renewed determination to make a difference where I can. Willingness to be angry or sad because itís ok to feel those things when injustice or just bad luck happens and it means that I really do care. Realizing that Iím not burned out or becoming apathetic.
I did that exercise straight through, so itís probably pretty representative of the actual process. No real editing was done J . Anyway, Iíve yet to find a situation where I couldnít do this Ė not that I remember most of the time, but when I do, it helps a lot. I havenít denied how Iím feeling, I have worked on understanding what Iím feeling and Iíve looked at why I have the feelings I do and then Iíve given myself a more realistic look at the situation. Iím still freely feeling but its not controlling me and Iím not pretending it isnít there. Iíve integrated it with my intellectual self and because of that; I understand myself and the situation better than before.
Hope this didnít sound too out there Ė Iím sure I sound a bit the new convert Ė I guess maybe I am Ė itís 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.