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Birth Trauma - My Story

Posted on 25 April, 2018 at 0:10 Comments comments (1)

My Birth Story

Monday, April 23, 2018 12:03pm

This morning I sat in the quiet of my office looking through baby pictures of my daughter. Those photos, taken over 5 years ago, show a beautiful, healthy baby girl, smiling and cooing. They show her father snuggling with her, showering her with kisses, and playing games of “upsy-downsy” and “jiggy-jiggy”. And they show me; her mother. I’m smiling in these photos, laughing, making eye contact with the my new Love. But these pictures don’t show what I remember about this time in my life. There are no shots of the countless diaper changes I conducted while uncontrollably sobbing; no flashes of the endless nights I spent sitting up in bed in between my sleeping partner and infant silently crying. These pictures don’t reveal the fear, confusion, and loneliness that dominated my world in that first year of my daughter’s life. That first year, when I became a mother, something I’d always wanted to be.

My birth story, if told from the eyes of an onlooker, is perhaps typical, even beautiful, but certainly not traumatic. Not unless I tell it. Not unless I tell you about what went on in my mind for those 12 endless hours. Not unless I tell you about what happened for 12 months after delivering my baby. Perhaps this is why, despite being a Mental Health Professional myself, I missed the trauma in my story. And I missed getting help until months had gone by. Perhaps this is why my Care Providers missed the trauma in my experience also.

My daughter was born in my home at 10:42 on an October morning in 2012. My partner and I prepared for her birth by hiring a Doula and taking Hypnobirthing Classes privately with her. For anyone who’s ever heard a woman talk about giving birth, they’ve likely heard enough about the pain experienced to elicit at least a small amount of anxiety. This might be what appealed most to me about the Hypnobirthing theory, which suggests that labour and birth is not painful, but rather that we have ascribed pain to the experience as a society, and this creates fear. Perhaps it was how I was taught this birthing method, or my desperate need to believe that my labour could be pain-free, but I convinced myself that in order to have a “successful birth”, or an “easy” birth as hypnobirthing so frequently states, I would have to not experience pain at all (did I mention that I am a people-pleasing perfectionist at my core?).

Well, I went into active labour at 9:30pm and by 10:30pm I was so engulphed in waves of pain that I felt someone was ripping out my organs and breaking my spine. I lost nearly all ability to speak, so for the next 12 hours, I spoke only a few words. One of my midwives had told me earlier that my baby was “sunny-side up” which I later learned was a cute way of saying that she was in a posterior presentation, which I found out can lead to some of the most painful contractions. Since my Doula was present, and I desperately wanted to please her as a good hypnobirthing student, I tried dutifully, though in vain, to use the tools she’d taught me. But there was so much pain and as the hours passed, I was so exhausted I could not hold my own head up. My nausea was constant, something else I did not know could be a part of the birth experience, and this completely inhibited by ability to eat or drink anything, which further compounded my exhaustion. My body no longer felt as though it belonged to me, and I had no control, my contractions coming with such frequency and intensity that I was thrown to the floor.

By the time a few hours had passed, I could no longer stand, and had to crawl from room to room, making my humiliation complete. At some point, I broke down, and feeling incredibly ashamed, whispered to my partner between contractions that I wanted to go to the hospital. He relayed this information to my Doula, who, sadly, following what she believed to be best practice, ignored this request at this time and the two other times I begged to go to the hospital during those 12 hours. Just before Transition, I remember having the thought that I wished I was dead, which led to a further wave of shame and guilt, since of course, if I was dead, this also meant that my baby would be dead. My daughter was not even in my arms yet, and I was failing her as a mother.

During this entire experience, I did not cry out. In fact, because of the difficulty I had speaking, and my desperate need to “succeed” at a pain-free, “easy” hypnobirth, the photos of my labour and delivery show me appearing to be asleep much of the time, or in a state of deep calm. This further compounded my situation since, in addition to being unable to voice my terror, my care providers could not see the terror evidenced on my face or in my body language.

Most definitions of trauma focus on the event itself, such as the Oxford’s dictionary definition of trauma as being “a deeply distressing or disturbing experience.” Or Tara Brach’s definintion: “Trauma is when we have encountered an out of control, frightening experience that has disconnected us from all sense of resourcefulness or safety or coping or love”. Peter Levine defines trauma in this way: “Trauma is not in the event itself; rather trauma resides in the nervous system.” It affects the body, emotions, mind, spirit, and our capacity for relationships. The three components that seem be present in trauma include that: 1. The distressing/disturbing experience was unexpected. 2. The person was unprepared. And 3. There was nothing the person could do to stop it from happening. Check, check, and check.

Birthing my daughter was, to me, a terrifying, lonely experience, in which I was a prisoner of my mind and body; in which there was no hope and no way out. I knew that since I was not supposed to be experiencing pain, the level of pain I was in meant that I was not going to survive this experience. And I knew that since I could barely speak, no one knew that there was something terribly wrong, so there would be no help, no rescue, no end to this terrifying experience. While labouring to become the mother I’d always wanted to become, I believed that I would not survive long enough to hold my baby girl.

But I did survive. In those first few hours after my daughter was born, the powerful effects of oxytocin saved me. I felt nothing but love and peace and deep connection. But when that powerful hormone waned, I sat in the dark of our bedroom replaying her birth, feeling frozen in fear once again, tears falling in silent unending streams down my cheeks. Weeks passed like this where I could not sleep for more than 20 minutes at a time. My daughter thrived, and I was deeply in love with her; a love I can still barely explain. I did not, as some of my Mental Health providers later insisted, feel any resentment toward her, or a lack of connection, which could have been indicative of postpartum depression. What was wrong with me? I questioned myself daily, knowing that although I met the criteria for depression, there was something darker stirring within me. My baby was fine, my labour was seemingly uneventful – no emergency c-section, no horror story of hemmoraging, no nights with my baby in a NICU away from my arms. So what was wrong with me?

I now know that I may have been asking the wrong question. It wasn’t “what’s wrong with me.” It’s what happened to me. It’s how I adapted to cope and survive with what happened. During my labour, overtaken by unexpected and unparalleled pain and terror, I had a flight or fight reaction which flooded my system with adrenaline and cortisol which overrode any pain-relieving benefits of oxytocin that would have been in my system while I was labouring. This likely also lengthened my labour, but explains why my pushing phase was relatively short, since adrenaline is actually helpful at this stage of labour. I adapted to my intense fear by trying to appease and please my care providers, especially after my request to go to the hospital was ignored not once but three times. This is how I adapted to cope and survive.

After about a year, I realized that I had been experiencing PTSD, which has 5 criteria: A. Being exposed to the perceived threat of death, B. Intrusion symptoms, C. Persistent avoidance of stimuli associated with the trauma, D. Negative alterations in cognition and mood, and E. Alterations in arousal and reactivity.

It took me a long while to find a practitioner whom I could trust to help me with this particular trauma. “What we now know is that trauma affects the whole person; mind, body and spirit therefore recovery also has to take into consideration the person as a whole.” – Trauma-recovery.ca

I sit here today, with my second daughter, unborn, sleeping under my heart. Years later, having gone through hours of talk therapy and EMDR trauma treatment. Having just begun to tell and retell my story with less shame each time. Weeks away from birthing my second baby, I am now able to look, albeit hesitantly, at those deceptively serene pictures of my first experience of labour. I’ve told my new midwives my story and my fears.

Since that October morning nearly 6 years ago, I have become a certified meditation instructor, and I’ve geared my psychotherapy practice to support women and their partners in their own birth and parenting experiences. I’ve learned about MBCP, Mindfulness-Based Childbirth and Parenting, a course which fits more in line with my values, and helps me to create reasonable expectations of both myself and my labour experience. It has also provided me with a deeper understanding of the role that pain plays in childbirth, as well given me some more tools to cope with it. Rather than believing that pain in childbirth is an indication that something is terribly wrong, I believe it is a part of labour, and my new mantra is to remind myself that “this belongs.” I’ve begun to prepare lists of phrases that I need to hear while labouring, as well as phrases I can point to in case my ability to speak is impaired again. I have planned a second homebirth, with the understanding among my care providers that if I ask to go to the hospital, their response will be swift and reassuring.

One of the memories I hold onto today is of the moment that my daughter was born and safely in my arms. That blissful moment when all my pain ceased and I was flooded with profound feelings of love, safety, connection, and peace. I can do anything for one minute at a time. And now I see that each minute of the childbirth process is a minute closer to holding my new baby. Each minute of labour for me, will be a labour of love.

Jon Kabat-Zinn, one of the first teachers of Mindfulness in the Western world, states that “Every baby can be seen as a little Buddha or Zen Master; your own private mindfulness teacher…” And I believe that this teaching, if we are open to it, can begin even before our babies are born.


A Reflection on My Meditation Training

Posted on 16 February, 2017 at 14:50 Comments comments (0)

My Experience Teaching Koru

Amanda Youssef, MEd, RP, CCC

September 5, 2016

It’s September, and I’m preparing to teach my 6th Koru course at McMaster University. The campus that was quiet over the summer months, is now buzzing with new students and a new semester full of promises and fears. Some students are embarking on the first in this new chapter of their lives, while for others, this is the beginning their final chapter in their educational careers.

I began teaching Koru to McMaster students in the Fall of 2015, eager to provide this as an adjunct service to the increasing numbers of students seeking mental health services from our Student Wellness Centre (SWC). I have served there as a Counsellor and Psychotherapist for 6 years, providing individual counselling as well as running a number of groups to try and manage the growing number of students with mental health concerns. Some of the groups I facilitate are structured, such as Dialectical Behaviour Therapy, and others, are psychoeducational groups I’ve developed including Building Healthy Relationships, and A Group for Every Body (for body image and disordered eating behaviours).

Part of my job in the SWC is to provide triage, that is, walk-in consultation appointments for students seeking counselling for the first time. As a treatment option, I often assign these students to groups during these appointments. Despite the fact that the SWC provides over 15 different groups, students are often quite hesitant to attend groups, and prefer individual counselling, which of course, compounds our difficulty to keep up with the demand. Not so with Koru. There is something special about this group, which from the start, required no cajoling or persuasion on my part in order to get students to participate. In fact, the SWC now runs this group several times a semester, offering it at different timeslots to meet the differing needs of students’ timetables. This also allows us to keep group numbers small. While I have run a group with 14 students, most of my groups have had 4-5 students participating, which I’ve found to be optimal for my personal comfort and teaching style. My groups have been very mixed, consisting of undergraduate, graduate, and medical students, of a variety of ages and ethno-cultural backgrounds. Some students have referred themselves to the group, while others have been referred through the SWC, whether by a triage appointment, through another clinician, or through one of our programs on campus. They report that they attend for a variety of reasons, but it seems to come down to the desire to manage stress and find new methods to contend with anxiety. Some have a basic understanding of mindfulness to begin with, and attend Koru with a wish to build on this and connect with a community with which to practice, however, for most, this is their first foray into the world of mindfulness and meditation.

I find myself gratefully amazed at the retention rates of our Koru groups. Despite the fact that their schedules are already too busy, students commit to attending the four weeks of class. They pour in great dedication to their new meditation practices and mindfulness activities, and share week after week with one another, developing bonds with each other that often extend outside of the walls of the Koru classroom.

As I have taught the Koru skills over the course of this past year, I have learned the value of using the skills in my own life. Not only do I then benefit from the skills themselves, but I find I can more readily answer some of the questions that come at check-in with the awareness that comes out of my own (still limited, but growing) experience.

Each group I teach, in turn, teaches me valuable lessons. For example, one of my students used dynamic breathing when she was crying uncontrollably following a breakup with her boyfriend. She found it very effective, and I was honoured that she shared this intimate experience with our class.

Inevitably, by the final class, most students report personal growth resulting from their new mindfulness practices. Perhaps one of the most heartening changes I witness, are the small alterations in students’ speech over the course of the four weeks that indicate an increase in their self-compassion.

Indeed, small incremental gains in my own self-compassion is one of the many personal changes I have noticed since beginning my Koru training last summer. Before this training, I’d had some mindfulness background, both personally and professionally, including using mindful birthing to birth my daughter at home nearly four years ago. My Koru training began with its own challenges, as I slipped a disc in my spine on the first of the five days of training. In Petaluma, California, far away from my home in Ontario, Canada, I once again, had the opportunity to allow mindfulness and meditation to be my partner in pain. Since then, mindfulness has infused my life. My work both at McMaster, and in my private practice is laced with mindfulness based therapies, including Koru. This likely would not have happened if I did not also feel changed as a person by mindfulness. I now have a daily meditation practice, which includes nightly meditations with my four year old. She has recently completed pre-school, where they have since adopted meditations at nap time, thanks to my daughter’s tendency to share about her home life! I am beyond thrilled to know that the Koru training I received has somehow led to a pre-school practice that will continue even though our time there has come to an end! This seems to be the potential of Koru; to spread in ways unimaginable and uncontainable. When I think of each student at McMaster to whom I teach Koru, the potential lives that may be positively impacted by a ripple effect is immeasurable. How truly beautiful that I can bear witness to some of this.

I was surely unaware of what I was headed toward when I boarded that plane to California in the summer of 2015. Certainly, I cannot fathom the new paths this mindfulness road will take me. But I do know one thing, I will be forever grateful to my Koru Instructors, Holly, Libby, and Jennie, for Koru, and for their patient and effective way of teaching it. 

 


Using Love as a Mindfulness Tool: Allowing our Children to be our Mindfulness Teachers One Moment at a Time

Posted on 2 September, 2016 at 9:45 Comments comments (1)

Mornings used to be my time.  Quiet, uninterrupted, space for me to enter the stillness of the world at my own pace.  I'd wake at a reasonable hour, say 7 or 8 am, work out, stretch, listen to music, shower, eat breakfast, and walk into work feeling ready for my day.

Enter: parenthood.  Somewhere during my pregnancy over 4 years ago, I surrendered quiet mornings for chaos and hurried mental lists to complete, while trying to get all humans and animals awake, fed, and ready for their day.  I have set my alarm earlier and earlier, craving some alone time and peace before my morning meditation is interrupted by the simultaneous patter of furry paws, and my daughter, Gwendolyn's, body crawling ontop of my cushion.  Sigh.

This morning was no different, except that today is my daughter's last day of preschool.  So, while making Gwen's ponytails, I was envelopped in emotions of grief, sadness, worry, and excitment for the ending of this chapter of her life, and the beginning of a new one.   I rushed through making her breakfast, forgetting to make mine, so that I could finish writing her teacher's thank-you card.  When Gwen came in to hurry me along, excited that both daddy and mommy were going to escort her to preschool for her special last day, I snapped at her in frustration.  "Stop rushing me!  Go put your shoes on and let me finish this!"  I didn't even look at her when I threw these biting words.  Rather than recoiling, Gwen took one step towards me, put her hand gently on my arm and said, "Mommy, remember you love me."  In an instant, my frustration melted.  I looked at Gwen, who stood with her head leaning to one side, looking intently into my eyes.  

She was quite unaware, I'm sure, of how she stepped into the role of being my Teacher in that moment.  Of how quickly those words pulled me from my whirlwind of stressful thoughts.  She was only remembering what her dad and I always tell her:  "No matter what, Gwen, even when we are angry, or frustrated, we love you."  She checks this fact often, testing its accuracy.  I'll be running her bath, exhausted, my back screaming at me to go and lie down.  It will be late, past Gwen's bedtime, and I'll be too tired to smile.  I'll look mad, or sound irritable.  And while drying her off, Gwen will say, "Mommy, you love me."  Not a question.  A statement.  A reminder.  A teaching moment for me, as much as for her.  And I confirm, mirroring back the truth of this, "Yes, Gwen, I love you.  Mommy is tired and grumpy right now, and Mommy loves you.  I always, always love you."

Gwen has always been a pulsating ball of love.  And love's a good reminder for me.  It's a good mindfulness tool, snapping me back to this present moment.  Pulling me from my ever-rushing and noisy "thinking mind", reminding me of my priorities, and of what is real.  Is it important for me to be on time for work?  Yes.  Is it important for me to get this thank-you card written?  Yes.  Is my relationship with my child, her emotional health, more important than both of those things?  Yes.  My answer to that question will always be, yes.  Yes, Gwen, in this moment, Mommy loves you.  

John Kabat-Zinn likens children to live-in Zen Masters, and raising them mindfully can be like engaging in an 18 year meditation retreat.  That is, if we let our children teach us.  If we let these moments in.  The moments when our children, in their innocence, move toward our frustrations and feelings of anger, touch us gently with their presence, and remind us of what is truly important.


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