Author Archives: Donna Rothert, PhD

Talking About It

talking about it

 

“If we knew each other’s secrets, what comforts we should find.”  John Churton Collins

“You know what truly aches?  Having so much inside you and not having the slightest clue of how to pour it out.”  Karen Quan, Write Like No One is Reading


 

Years ago, sometime after I became an adult, but before I had experienced much in the way of loss, I had a doctor’s appointment with someone who was covering for my regular provider.  I wasn’t there for anything urgent and I don’t remember many details about the visit.  I do, however, remember one thing very clearly.  In the midst of the chit-chat between me and this 40ish physician, she mentioned something sweet that her daughter had done.  She then gently added “she’s passed away since then.”  After this comment, she continued to talk and move through the rest of the appointment in a calm, warm and professional manner.

I’d like to tell you that I said something kind, respectful and connecting in response to the doctor’s statements, but I highly doubt it.  I just remember being floored by the mention of a dead child.   I felt stunned, sad and awkward.  It probably showed.  It was hard for me to imagine that this woman had gotten up that day, had breakfast, dressed for work and was keeping a not all that consequential appointment with me, all while her daughter was dead.  It was also startling to me that she could talk about her daughter in such a natural and beautiful way.  After all these years, I still think about it.  It was a challenging, memorable and helpful moment for me.

“Talk about it.”  It’s advice often given to the bereaved.  We probably all have ideas as to why this is a good idea.  It can feel relieving to share feelings instead of having them bottled up inside.  Talking about the loss can also be a way to connect to others and to feel less alone.  Better talking than acting out in some more negative fashion such as overworking, drinking or drugs, right?

It may also be an important way for us to take another look at ourselves and acknowledge who and where we are.

In the pregnancy loss group I used to facilitate, whenever a new member joined, each member, beginning with those who had been in the group for awhile, would tell their baby loss story in whatever level of detail they felt comfortable doing so.  Sometimes this brought up anxiety for people as they anticipated what it might feel like to revisit the events that they experienced as so acutely painful.  There were usually tears and sometimes trembling voices.

However, as time went on and people retold their stories, they would often comment on how their stories changed as they revisited and shared them.  There were still tears and sometimes trembling voices.  But there were also different details noted as more or less important and changes in emotional resonance.  Over time, group members seemed to hold their loss less as a “hot potato” or cut-off portion of their lives and more of an integrated part of their history.

That single comment made by someone I met only once helped me because it challenged the way I thought about grief and what it must be like to lose someone so critical to one’s identity and happiness.  It felt like a significant dispatch from one woman’s experience in the field of grief.  The doctor helped me consider the possibility that a person can live with a profound absence in her heart without having her heart close down entirely.  She showed me an example of a person respecting her own grief, her lost child and her ongoing life.

Of course, I don’t know what the physician’s mention of her daughter and her loss did for her.  But that one encounter made me think that an ongoing conversation about one’s loss may be the way to go.  The conversation may be a lot of monologues interspersed with dialogues.   The audience may be one or larger.  It may have many twists, turns and moods to it.  It may make people uncomfortable.  If may help them immensely.  It may do both.  It may help connect some dots and fill in some colors to help others understand us.  It may give us a clearer view of ourselves.

 

 

Thinking About Trying Again

“I am half agony, half hope.”  Jane Austen,  Persuasion 

“I’ll never know, and neither will you of the life you didn’t choose.  We’ll only know that whatever that sister life was, it was important and beautiful and not ours.  It was the ghost ship that didn’t carry us.  There’s nothing to do but salute it from the shore.”  Cheryl Strayed, Tiny Beautiful Things:  Advice on Love and Life from Dear Sugar


h

In the midst of, or immediately after a baby loss, a giant elephant of a question usually takes up residence with us.  It tends to come with a number of spin off questions and fears.

Can we try again?

Will we try again?

When will we try again?

What will happen if we try again?

I’m afraid that’s it’s the only way I’ll feel better.

I’m scared that I’m trying to replace my baby.

Will everyone forget my last baby?

How will I get through another pregnancy?

What if we lose the next one too?

I always feel a bit startled when I to read an article or book on loss that recommends people not make any major life decisions while grieving.  How might that work with baby loss?  It’s not like pregnancy or infant loss comes with a fast pass to travel through grief or an extension on the childbearing window.  And that baby longing probably isn’t going anywhere either.

But I understand where those writers on loss are coming from when they express this concern. There is, of course a difference in jumping to a decision immediately after a loss vs. waiting some weeks, months or longer. Waiting allows for some important processing of your feelings and I recommend giving yourself whatever time and space you can.  However, my experience is that the feelings accompanying our loss will still be actively living with us when other factors compel us to make a decision about trying for another baby.

Your brain on grief may not be the best one for choosing what neighborhood to move to or what kind of car you’ll need for the next ten years.   In the midst of grieving our babies, it may not seem possible for us to do a good job of assessing decisions that require weighing facts and anticipating the needs and desires of our future self.  Yet, somehow, that’s exactly what we do.  We have to and we do.


This is the part where I wish I had a roadmap to give you so you could know what direction to go in and feel sure that you would get there.  You definitely deserve such a thing.  I’d love to have a map that would guide you through the decision about trying for a pregnancy or other family building option when you are heartbroken and know that pregnancy does not always equal living baby and that sometimes things can go so terribly wrong.  I would post it here, I would tell all my clients and anyone else who needed the information.  But I think some places we visit in life don’t lend themselves to mapping– the terrain just isn’t clear enough for everyone to see it the same way.  For that reason, this walk is less a determined march and more a humble exploration.

That said, you are traveling a road with lots of others ahead of you and alongside you.  Some things are known.  Some landmarks, and places to pause, have been identified and can be pointed out.

A first stop is often where you spend some time trying to understand the risk of recurrence of whatever version of pain and bad luck struck before.  This may be a short visit or a long layover.  Medical appointments, tests, procedures or research might all be needed or desired.  And then there will be a time to stop doing those things, remembering that you can google your heart out and will still never get the specific answer to the question “what will happen if I try again?”.

Less objective is ascertaining what we are up for emotionally.  Trying for a baby at any time is a leap of faith.  When your previous leap has landed you face down at the bottom of a gully, it makes sense to evaluate whether you are up for trying again.  The place where you examine  your feelings is another stop on the road that may be approached in fits and starts and will probably take a lot out of you.  It’s also one that deserves your time.

The spot where you at last make your decision may take many attempts to reach.  The decision itself may look familiar or it may be brand new.  You might be clear that your heart pulls strongest in the direction of trying for another baby in whatever manner you did before.  As scary as this might be, it may feel very right to try again as soon as possible.  It may fill you with hope.  It may feel healing.  The task at this point becomes how and when to best support yourself in this direction.  It may be useful to remind yourself often that, regardless of outcome, this will absolutely be a different pregnancy or baby than the one that came before.

You may also decide to try in a different way than you have tried in the past, such as with assisted reproduction or family building through adoption.  Trying in a different way requires learning and investment,  but may be indicated for medical or emotional reasons.  For some people it gives an extra benefit of a delineation of this experience from the previous one.  Any direction, though, is still an adjustment from the path you were on with your previous pregnancy or baby.  Any direction, even standing still, is at some point a decision.

Finally, for all kinds of reasons, you may feel that your best decision is to remain child-free or without more living children than you already have.  This could be due to age, finances or the understanding that this direction can lead you to a happy and meaningful life.  Finding others who have had done the same thing may help.  One option is to look at the RESOLVE website for articles about living child-free.  Acceptance and enjoyment of the life you have can’t be forced, but it can be found.

The decision of whether or not to try again for a baby after perinatal loss tends to be a combination of fact finding and soul searching in the midst of what can be debilitating pain.  It’s often a question that stops us in our tracks with fear or confusion and wakes us up with need and hope.  After baby loss we are usually keenly aware that we have not and will not be offered a risk free life.  We are not calling all the shots and wherever we end up on our decision making path,  it won’t end in a flag raising.  But the combination of hope and intention is powerful.  It contains in itself some meaning and beauty.  At the end of our path, it’s our moment to pick up our dandelions, take a deep breath and blow.

Preparing for Take Off

h


“The Guide says there is an art to flying,” said Ford, “or rather a knack. The knack lies in learning how to throw yourself at the ground and miss.”
Douglas Adams, Life, the Universe and Everything 

“I’m learning to fly, but I ain’t got wings.  Coming down is the hardest thing.”  Tom Petty Learning to Fly


The pilot in my life has tried, repeatedly and unsuccessfully, to teach me the physics of flying.  So far there is only one fact that has really stayed with me.  It’s this:  after we have put fuel in the plane, ensured all the parts are working, buckled in, started the propeller, communicated with the tower, moved the throttle, flicked lots of switches and gone skittering down the runway in that wonderful, jerky fashion of small planes, after all of the steps and effort are made by the pilot to leave the solid surface of the earth, it is the air flowing over the wings that pulls the plane off the ground.

This piece of knowledge is remarkably unhelpful in moving me toward my goal of being able to land the airplane in an emergency, but it does help me make sense of some other things.  It’s a great reminder to me of how our piece of an endeavor may be big, complicated and important but, ultimately, not the whole thing.

Sometimes when the pilot and I intend to go flying we are stopped by clouds, wind or VIP events declaring jurisdiction over the air we wanted to travel through.  Once, we got in the plane, did all the steps to run up and were sitting on the runway when it became clear that an instrument wasn’t working properly.  Uncertain of the cause, we had to scrap the flight.  The last time we planned a weekend trip, changing weather forced us to decide against three successive destinations and we ended up driving to a nearby town instead.  Being a small aircraft pilot is both powerful and humbling– you get to do big things much of the time but are also always at the mercy of greater forces.

As a clinical psychologist, I feel that I have an honorable and important job.  I spent many years learning about human behavior and theories of how to help people.  Psychotherapists are given trust, privilege, and responsibility as we sit with people and look into their lives with them.  We are capable of having a great deal of influence over others and the results can be life-changing.  But the impact of our work is still limited by multiple factors.  Timing, skill, communication, chemistry, intention and motivation and other issues between a client and therapist might affect how things progress in a given moment or session.  For better or for worse, the result can never be entirely in our hands.

After baby loss, people are always trying to do something.  It’s usually a big thing, even if it doesn’t appear that way to others.  Sometimes it’s a bunch of big things.  It may be letting themselves feel more pain than they have ever felt before.  It may be trying to find a way to get through much of the day without crying so that they can return to work and keep their job.  It may be walking into an AA meeting for the first time, because the way they have been trying to cope isn’t working.  It may be sitting with that weighty decision of whether or not to try for another baby.  And whatever they are trying for may or may not take off.  Chance, effort, ability, help from others, and grace may all factor into the final result.

Living after baby loss, like living the rest of life, is about trying for the things that matter to us.  It just tends to be a hell of a lot harder than most of the other chapters we’ve lived.  We don’t know if we’ll get what we’re trying for, we just get to do the part that is ours to do.  We can only try to be there in the right position, moving at the right speed and holding on tight.

 

Glimmers

h

“But the truth is, the ten or twenty minutes I was somebody’s mother were black magic. There is no adventure I would trade them for; there is no place I would rather have seen.” Ariel Levy, “Thanksgiving in Mongolia”

“You can close your eyes to reality but not to memories.”  Stanislaw Jerzy Lec


“I don’t want to forget her.”

“I can’t stop thinking about my baby.”

“Remembering and being sad makes me feel connected to him.”


Sometimes I get questions about what it’s like further down the road.  People want to know what it will be like after years have passed and they become older and are people who did or didn’t have more babies and who have had more life happen to them.  They wonder what it will be like after they have lived a long time without the baby they lost.  Will the memories of their baby or pregnancy fade away?  Will they remain all too vivid?  What will they feel about it all?

For any given person, I have to say that I don’t know for sure.   I can’t know.

There are things we know about what usually happens.  People don’t stay in the worst part of their pain long term.  Most people don’t get post-traumatic stress disorder after baby loss.  For those who do there is treatment.  Most people eventually return to their baseline of happiness. Again, help is available for those who need it.

And, as usual, life will continue to involve a lot of fluctuations between the zoom and macro lens view of our lives, including our losses.

When it comes to baby loss experiences, we tend to be ambivalent about our memories.  Losing the memories would mean that nothing remains of the relationship and experience.  The disappearance of a memory, as in the movie Eternal Sunshine of a Spotless Mind, would mean the disappearance of part of our lives and part of us.  And the too vivid version?  We’ve already lived that experience and were probably terrified of being stuck there.

A memory and its accompanying feelings can sometimes attack us with devastating intensity. This tends to happen more often in the early weeks and months, or in response to anniversaries or other specific triggers.  However, these strong, surprisingly painful “grief bombs” (as labeled by one of my clients) may be an ongoing, occasional, part of our lives.  These  sudden attacks can feel upsetting but they can also feel like a time of connection to the baby and an important part of our history.

Memories may also be sought out– by bringing up the baby in conversation, poring through pictures or writing down what we recall about the baby or pregnancy.  For some people, the need to honor and share about their baby is passionate, overt and embedded in their daily lives.  (An excellent example of being “out” in this way can be found in Cherie Golant’s article “My Baby Died and I Can’t Shut Up About It” on Medium.com.)

For others, the honoring and remembering may be a more private, although no less sacred part of life.  Support groups, whether online or in person, can often help such people in providing a safe place to express memories and feelings to those who are most likely to be able to understand and bear witness to the pain.  Yearly memorials may serve a similar purpose.  Others may find journaling or art to be the most effective routes to connect and think about their babies.

Connecting with and remembering a baby can also happen in very subtle ways.  Every spring, I look for the tiny blue flowers that were in bloom when my baby died.  When I see them I feel a small, strangely comforting sense of visiting the events of that time.  I think about the experience of carrying and losing her and the mixture of sad and loving feelings I continue to hold.

Memories can pass through and briefly light up something in us.  They can remind of us what happened and how our lives have been changed.   They might be reminders about connection, impermanence, enduring love, staggering pain or the capricious nature of the world.  They might be about living through hell and still living.

You will look back as you move forward.  Sometimes you’ll smell something, feel something, know something because of where you’ve been.  The part of you that loved and lost someone will still matter.  Like the feeling of warm concrete against bare feet after the sun has gone down, your senses confirm what you know, that the glow was there.

 

 

 

 

 

When Sex Isn’t So Sexy

“We have so little faith in the ebb and flow of life, of love, of relationships. We leap at the flow of the tide and resist in terror its ebb.  We are afraid it will never return.  We insist on permanency, on duration, on continuity; when the only continuity possible, in life as in love, is in growth, in fluidity – in freedom, in the sense that the dancers are free, barely touching as they pass, but partners in the same pattern.” Anne Morrow Lindbergh, Gift from the Sea


h

“Since we lost our baby, I just don’t want to be touched in that way.”

“How are we going to try again?”

“I actually feel more interested in sex right now– is that weird?”

“We’ve been dealing with infertility and miscarriages for so long, sex has a whole different association for me now.  There’s nothing sexy about it.”


Sex and Meaning 

The most loaded of three letter words, sex can mean so many things to us: comfort, excitement, pleasure, intimacy, fun, freedom, and an affirmation of life.  It may feel like a physical need at times and a spiritual event at others.  It can feel like one of the best parts of life and the epitome of an expression of love between you and your partner.

Unfortunately, after baby loss, it can also mean:

Physical pain for the partner who carried the baby– this may be related to a vaginal delivery, C-section, termination procedure, discomfort related to lactation or other medical issue.

Emotional pain because you’re grieving and lots of things are emotionally painful right now.  If you are in a heterosexual relationship, sex can feel like a distressing reminder of how the two of you made a baby who can’t be here with you.  Having to use birth control during the time you expected to be pregnant can feel both weird and sad.  If you have had fertility challenges, it may remind you of another chapter of your reproductive history that has been painful.

Confusion regarding what sex means now.  Are you “back to normal”?  Trying again?

Guilt about doing something enjoyable.  You may feel like it is a betrayal of your baby to do something physically pleasurable.

Just impossible because you don’t feel comfortable in your body, because sex is playful and you don’t feel playful,  because you need to feel safe to feel sexy and that is not your world right now, because you need to feel vulnerable during sex and you can’t stand to be any more vulnerable, because you experienced a trauma associated with your delivery and now sex triggers anxiety, because you’re too exhausted, because you’re too preoccupied or for any other number of other reasons.

Or, especially appealing because you need to feel comforted, connected, alive or not alone and sex is providing that for you.

If, since your loss,  you’ve been feeling upset or disconnected about the idea of sex, you are not alone.  Your feelings are totally understandable and most likely temporary.


“Cause when a heart breaks, no, it don’t break even.”   The Script,  Breakeven


Sex and Partnering

Sharing a pregnancy or baby is, in itself, a form of intimacy.  A baby is of us and of our relationship in a primary way.  Babies are either biologically connected to us or made with hope, planning and intention involving donors, surrogates or additional birth others.  Going through a pregnancy or having a baby with a partner tends to be a time that stands apart from the rest of our time together.  We may have higher highs, lower lows, and scarier scares together.

It is generally a time of greater interdependence and greater need for a couple as they undertake a journey together to bring a new human into the world.  Even if multiple pregnancies have come before or are expected in the future, this time is a bit different.  The wishes, fears, expectations and memories of a specific pregnancy are exactly that, specific to that pregnancy and special in their own way.

And after baby loss?  I think the heart can’t break even.  And the physical fallout of perinatal loss is never even.  Although so much can and usually is shared in terms of a couple’s reactions, one person is more likely to have been more attached to the baby or more ambivalent about the pregnancy or more physically affected by the loss than the other.  I  don’t think it’s necessarily that one partner feels more or less overall.  I think it’s more that the jagged edges of the broken place for each person are just not exactly the same.  Maybe similar, maybe just as painful, but different.

So wherever you and your partner might be regarding the reactions to sex listed above, you likely have some significant differences.  In addition, you lost some things as a couple such as your identity as an expecting couple or parents of a new baby and your dream of where that path would take you.

With the loss of the baby is a loss of what you hoped for and expected together.  You are both at least a bit changed by your loss and part of what you shared is gone.  This can feel like a new world that you have to learn both individually and together.  The feelings of acute grief and the need to relearn your connection with each other may make sex intimidating or unappealing for some time.  This can feel like a huge secondary loss, but it is probably a short-lived one and one you can work on.


“After you experience the loss of a loved one, a solid boundary suddenly stands before you.  It feels as though you’ve hit a hard wall, and you need to find some softness in your life.  Death is the breaking of a connection, while sex can be the establishment of one.”    Elizabeth Kubler-Ross


What Can Help

If your sexual experience with your partner feels out of sync, it may help to remember that this is more likely to be a phase of your relationship rather than a permanent change.  You both are hurting from your loss and coping in different ways.  Here are some suggestions of what may help during this time as you find your way back to each other.

Start Slowly because you’re not exactly the same as you were before your loss and it’s unlikely that your sexual self will be immediately back online.  Having that in mind and managing expectations can help you and your partner give each other the time you need.

Communicate needs and meanings of sex now.  Communication is itself a form of intimacy in that it helps you to know each other better and offers opportunities to connect.

Accept differences in reactions and coping mechanisms.  Physical intimacy may feel comforting to one of you and not so much to the other.  It doesn’t make one of you wrong, it just may take some time to bridge the gap.   In The Five Love Languages:  How to Express Heartfelt Commitment to Your Mate, Gary Chapman popularized his idea of “love languages”.  The idea is that people have their love tank filled by different means, which he categorized into the areas of physical intimacy, quality time, acts of service, gifts or words of affirmation. As a general concept, this can be helpful to consider when you and your partner seem to express and feel love/intimacy in different ways.

Broaden your definition of intimacy by discussing what makes you feel close, connected or turned on and considering new possibilities. Even after you have communicated and worked on accepting differences, there may be ways to expand what feels connecting to each of you.  For example, in the realm of physical intimacy, if sexual intercourse is not the right thing for one or both of you right now, experiment with holding hands or massage as a starting point.

Spend Time Alone Together and consider how you would like to use it.  Walking, talking, crying, or sitting together can all be healing and intimate experiences.

Learn About Sensate Focus, a technique developed by William H. Masters and Virginia E.  Johnson that was developed  for couples experiencing a variety of sexual challenges.  It involves a series of steps that focus on touch, initially non-sexual, to explore what is pleasurable.  It provides a structured and nonthreatening way to revisit a sexual connection that has been challenged for any reason.  For couples who have been through baby loss, it may take some of the pressure and triggers away from sexual intimacy by shifting the focus to a slow, physical exploration.

Get Additional Help as needed.  This may include individual and/or couples counseling.  A therapist can work with you or you and your partner to help you address barriers between where you are and where you want to be with your sexual connection.

Summary  

The intimacy of sexual expression between partners is related to the intimacy of pregnancy and having a baby.  Baby loss can turn the world upside down for a couple in so many ways, including their sex life.  By looking at your individual reactions to physical intimacy, noticing what is happening between you and your partner and experimenting with ways to reconnect, the two of you can return to a closer emotional and physical relationship.

 

 

 

 

 

 

 

 

 

 

 

Here Now

h

And it’s too early in the morning

And too late in my life

To write a different story

To hope for different lines…  

Cindy Bullens, The End of Wishful Thinking

“Acceptance of one’s life has nothing to do with resignation; it does not mean running away from the struggle.  On the contrary, it means accepting it as it comes, with all the handicaps of heredity, of suffering, of psychological complexes and injustice.”     Paul Tournier


I visited the New York City 9/11 memorial and museum a few weeks ago.  It was the first time I’ve visited a memorial to events that were clear in my memory, albeit experienced from across the country.  The pictures I saw there were jarring reminders of what so many of us saw on TV back in September, 2001– the planes crashing, the survivors running away from burning buildings, the family and friends frantically searching for news of their loved ones.

One exhibit featured photographs of people who were standing on the street that day in Manhattan watching the events as they unfolded at the World Trade Center.  They were in the middle of watching the world go off the rails and it showed in big eyes, crumpled faces, hand-covered mouths.  It made me marvel again at how anyone ever goes from such a moment, of seeing the unthinkable, feeling the unbearable, to having a good life.

There are some lines in life that we cross and from which we can’t backtrack. Those people on the street that day in NY can’t unsee what they saw on that sunny morning and I don’t know what their lives are like today.  I imagine that they range from struggling to doing quite well.  I think about how they did it– how they made room for so much.  I think about how others I have known have gone through so much and kept living and growing.  How did they ever start on that road?

The word that keeps coming to my mind is acceptance.  Acceptance in the sense of that simple and challenging task of allowing into your reality that this is actually where you are and what is happening.

I have met many people who have faced losses that they thought would take them down permanently.  People who were sure that the unimaginable big awful that had invaded their lives was not a thing they could make peace with, and certainly not something they could do something with.  That overwhelming pain in front of us can look like a bed of nails.  We are certain that only a cushion–  substances, denial, work, distraction, sleep, something, anything– can make it bearable.  We feel a need to steer away from the pain, feeling that meeting it head on will bring disaster.

What I would call acceptance, or being emotionally open to the reality that we wish was so different, doesn’t seem wise at first.  Who wants to get an up close look at all that pain?  But it is the one way to know what we feel and that we can live with it.  If we don’t want to play a lifelong game of whack-a-mole, where our suffering keeps popping up in different areas, I believe that the answer is to live our reality and know the part of us that feels broken.  Feeling it, and processing it through time and with support, moves us to feel something more than our hurt and more of what life has to offer.

In his book, The Gift of Grief, Matthew Gerwitz makes a case for what he calls “Surrendering but Not Giving In”:

“…the counterintuitive stance of openness, vulnerability, and engagement with our pain is actually the source of genuine healing–the approach that takes us beyond survival and back to living.”

Whether called acceptance or surrendering,  this is something that can be practiced.  We’re still going to feel overwhelming feelings and need to take breaks from them.  Defenses serve a useful purpose at times.  But we can start to invite ourselves to be open to acknowledging the places that hurt.  We can practice noticing where we are right now, without  filling in the space between what we think we can stand and reality.

How might this apply to the experience of baby loss?  Here are a few thoughts pulled from working with those who are working on acceptance after perinatal loss.

Tangible reminders of the pregnancy or baby can be useful in taking in the experience of loss.  Many people naturally do this and some push themselves to do it in small doses.  Looking at pictures, clothing or baby toys puts us in touch with the fact that it all really happened.  Whatever the good parts of the pregnancy or time with baby and the terrible ending were, they were real.  It’s all part of our life and part of us.

Connections with others can support us and facilitate our acceptance of the loss.  This can mean connections with the baby, such as visiting the grave, looking at ultrasound pictures or speaking to your partner about your memories of being pregnant.  Sometimes people find invaluable support from others who have been through similar losses, which can happen either online or in person.  It can also mean connecting with other loved ones who reinforce both the reality of what you have been through and that you are still upright and alive.

Notice thoughts that are taking you too far away too often.  It’s normal to start thinking about trying again immediately after a loss.  It’s usually extremely compelling.  Other thoughts of the future might also have a magnetic pull on you right now.  It’s often useful to question how much you’re shifting attention away from the present.  What are you feeling about your life right now vs. what might lie ahead?

I think Tournier was on to something in his quote about acceptance as different from resignation.  It’s too late to change the lines of our story to date and that can be fiercely painful.  But it’s not a white flag of surrender or retreat to accept our life in all of its alarming reality.  Instead, I think it’s another way to practice compassion and respect for ourselves while continuing to heal and grow.

And Then…

“Grief is in two parts.  The first is loss.  The second is the remaking of life.”–              Anne Roiphe

“It’s the song that I sing because I have to.”–  Cary Ott,  I Wouldn’t Do That To You


h

Unexpected loss shatters the story of our lives.  We are left to stare at the pieces, and at the new absence– twisting our heads to try to understand what happened and what can be done.  We hurt and we wander around inside ourselves.  And then?

Something else certainly follows, but I’m not sure that it happens in the way Roiphe describes above.  How does one remake a life?   Is a remake what we really need?  Might this second part of the grief thing be more about accepting and being in our changed life vs. remaking it?

Or maybe grief is never really any two parts, stages or any other neatly organized idea.  Maybe it’s just a hot, turning mess that we crawl, climb and pull ourselves through as best we can.  And maybe the weirdest part of grief is that it’s not outside of our lives at all, but just sharing space with everything else in it.

The book Knocked Up, Knocked Down (2010) by Monica Lemoine chronicles the lives of the author and her husband as they are hit by multiple pregnancy losses.  At the memorial for their stillborn son, Lemoine’s husband reads the following letter which speaks to the challenge of needing to both mourn and live:

Dear Son,

Forgive me when I cry.  It’s certainly not what I would have taught you to do.  Occasionally, I can’t help it.  I can’t help it when I see your mother’s face fill with pain.  I can’t help it when I replay her phone call in my head.  “There’s something wrong with the baby,” she said.  I can’t help it when times that were supposed to be so joyous are filled with crushing disappointment–the day of your baby shower, your due date, the three months of paternity leave that we would have spent together, all the baseball games that we would have watched and played.  Forgive me when I cry, and know that I’ll never forget the seven and a half months of joy you brought us.

Love, Dad

Dear Son,

Forgive me for the times that I don’t cry.  Most of the time, I can’t help but be happy, and it’s hard not to feel guilty about that.  I can’t help but be happy when your mother dances in the living room.  I can’t help it when family and friends visit and bring us food, prop us up with support, watch football and play ping-pong with us.  I can’t help but be happy that I’m married to your mother and knowing that we’ll make it, stay positive, and have more kids in the near future.  I can’t help being happy because it’s my nature, and your mother brings it out in me, as she does in everyone else.  Forgive me when I don’t cry, and know that I’ll never forget the seven and a half months of joy you brought us.

Love, Dad

This letter moved me the first time I read it and I returned to it later to consider what was so compelling.  I do find the immediacy of the grief touching.  But what stands out for me in a second look is that it’s a beautifully simple description of what it means to love, lose and then keep the door propped open to whatever feelings come calling.

There is no shying away from emotion in the words spoken by the Dad to his stillborn son.  Instead, there is an open acknowledgement of attachment and feeling.  He honors the baby who brought joy to their lives and the father-son relationship that exists (even without a living baby to make it tangible to others).  He also is open about his considerable pain as well as periods of happiness as he sits with a bewildering absence.

It’s so easy to do a “pile on” after baby loss– giving ourselves a hard time for having a hard time.  I hear this from the women and couples I work with in questions such as “am I dwelling on this?” or “how do I stop feeling this way?”.  Anxiety about “moving on” or “forgetting/betraying” the baby make emotional movement to the other side (feeling less intense sadness) a landmine too.  I remember feeling the same way.  There is nothing clear or elegant about the acute grief experience with all of the accompanying pain, fear and confusion.  It often makes a mess of us, at least for a while, and we want it to stop.  I wish I didn’t know what I look like when I cry and brush my teeth at the same time, but alas, from my time of living with the grief of losing my daughter, I do.  It’s just not a graceful time of life.

So I don’t expect anyone to have a composed or enlightened version of their grief.   I don’t find it useful to tell people how to feel.   But I am likely to suggest that they  notice what they feel.  I’m also likely to remind people that whatever our emotional state is right now, it will change.  The intensity of  pain we experience in grief doesn’t stay the same because it can’t.  And eventually, at whatever pace we need, some other feeling will appear.   The emotional song you are compelled to sing at any given moment may be one that makes you cry or one that makes you smile and the next song may be quite different.  It’s enough to keep a heart very busy.

Living with grief can certainly feel messy and chaotic.  It may make you feel a bit crazy to have your emotions become so unruly.  But it’s still you living a chapter of your life.  You may be flooded with feelings about your past and reliving memories sweet or tragic.  You may be full of  hopes or heart-fluttering fears about your future.  These are all signs of life.  The next chapter, whatever it is, is going to be more of you living, and by surviving whatever you feel right now in this moment, you’ve already begun.

 

Post-Traumatic Growth

“To grow, something must be either incomplete or damaged.”  Hansjörg Znoj

“There will come a time when you believe everything is finished. That will be the beginning.”     Louis L’Amour


h

“I experienced mother love and that has added to my life.”

“Surviving my losses has taught me more about who I am.”

“Now I see what’s important.”

 


Throughout different cultures and times, it has been frequently observed that the challenge of coping with an event that has brought about great suffering can also lead to positive change.  This is not to in any way minimize the emotional devastation of the loss of a pregnancy or child or any other painful and life-changing event.  It is only to say that from such a desolate place, people often undergo, in the words of Calhoun and Tedeschi (2006),  “positive change experienced as a result of the struggle with a major life crisis or traumatic event” or Post-Traumatic Growth.

This is a touchy subject to address.  It can be very challenging and uncomfortable to believe that something good could come out of something so painful.  Specifically, it can bring up concerns that any positive outcome after perinatal loss is somehow disloyal to the baby.  These are understandable and not uncommon worries.  It can also make people wonder– does acknowledging a positive side to a loss imply that you would choose to go through it?   I don’t believe so.  I know for myself that I would definitely choose the version of my life where my baby had lived over a chance for personal growth or any other prize behind door number two.

So this is an area where I tread carefully with bereaved men and women.  I usually do  a lot more following than leading toward this subject.  But I also think there can be a reason to go there.  I think it’s worthwhile, and occasionally life-saving, to know that others have been in your shoes and that they got through it.   Additionally, it can help to know that some of them, in their process of coping and understanding,  found that their lives changed in some way for the better.  It also addresses the concern that many people have after a life-changing event–  “How will I get back to normal?”  The answer may be that you won’t, and that may not be a bad thing.

What kind of positive change do people tend to experience after a life crisis?  In the Handbook of Posttraumatic Growth, Calhoun and Tedeschi note their qualitative research on PTG, which led to identification of five domains of growth.  The categories are new personal strength, new possibilities, relating to others, appreciation of life and spiritual change.  Here is a brief look at how each of these areas might relate to someone who has experienced a perinatal loss.

Personal Strength   I have often heard clients express surprise at what they have been able to live through.  Calhoun and Tedeschi capture the sentiment of many after a trauma,  “I am more vulnerable than I thought, but much stronger than I imagined.”  Having survived something they did not expect to face, people may approach the future with less fear.

In relation to perinatal loss, this can sometimes be helpful for those who decide to try to conceive again.  Trying again after loss is typically a very loaded issue in which people are balancing tentative hopes and vivid fears.  Faced with the prospect of investing again in a process where they are keenly aware that things can go wrong, people may be able to use the awareness of their strength to address the fears in another pregnancy.  They may feel that they can survive something so difficult because they already have.  For those who decide to not try for another baby, the knowledge of their strength may increase confidence in any future endeavor.

New Possibilities   If something unimaginably bad has happened, maybe the field of possibility can be stretched both ways.  Unexpected loss is a strong reminder that life can proceed in an unplanned and unanticipated manner.  Through both luck and effort, desired changes can also happen.

Women and men often speak of a broadened view of the world after a perinatal loss.  I have known many people to see the event as a crossroads in their life.  Some women and men decide to change professions to something that has more meaning to them.  Some people become very clear that they wish to become a parent by trying to conceive again, some decide to build their family through adoption or other ways and some decide they will not have children but will attach to other meaningful things in their life.

Relating to Others  Relationships with those who are still here can feel more precious when we’re missing our babies.   It may feel similar to the sentiment sung by Meghan Trainor, “I’m going to love you like I’m going to lose you, I’m going to hold you like we’re saying goodbye.”  We never know what lies ahead, and that uncertainty makes us want to embrace the time we have with those we love.  Despite the stress that perinatal loss puts on a couple, there can also be a sense of wanting to hold partners closer after loss.

Some family and friends may have offered themselves as support in a way that deepens and enriches the relationship.  Children, whether already in the family or imagined in the future, may be all the more valued.  Some people find that relationships with others who have experienced baby loss help them to understand their new world.  After a perinatal loss, many people report increased empathy for others in general, making all of their relationships feel a bit deeper.

Appreciation of Life   Perinatal loss puts us directly in touch with both birth and death, and is a reminder of how fragile life can be.  As a result, it can lead to greater appreciation of this life and this moment.   Feeling the warm sun on your face, sharing time with an elderly relative or engaging in a favorite hobby may all take on heightened value when one has been made so aware of the finite and uncertain elements of life.

Spiritual Change   Losing a baby often challenges our understanding of how the world works.  For some, that leads to a new or deeper understanding of spiritual connections.  A man who was raised in the Catholic church may find great comfort in returning to the rituals of the church to process and cope with the loss of his baby.  A woman may find increased meaning and spirituality in nature and the beauty she sees in her everyday world.  It is not uncommon to experience an expanded sense of being, which may bring up existential questioning and growth related to our place and purpose in the world.

Summary   Post-traumatic growth doesn’t always happen to those who have suffered loss and it’s not the only way to get through the experience and back to a satisfying life.  However, it can be important to know that it exists and that it doesn’t have to be big and dramatic to be meaningful.  Yes, some people will start an organization, join the Peace Corps, or in some other way show a dramatic change in the focus of their lives.  But that’s not the road for all of us.  We may experience our growth in other ways such as feeling closer to our loved ones, being more self-aware and compassionate or appreciating our world in a more profound way.

 

 

Partners in Pain

“Truth is everybody is going to hurt you:  you just gotta find the ones worth suffering for.”

 –Bob Marley


“I don’t think she should wallow in it and be so sad all the time.  I mean, there’s nothing we can do about it so let’s move on.”

“I don’t even know if he misses her or understands how I feel.  I wonder if I’ve lost him too.”

“He acts like everything is fine.  He says we just need to get pregnant again.  Does he think that will make it all better?”


hPerinatal loss is a huge challenge for any couple to face.  When we took vows to stand by our partner for better or for worse, we didn’t picture this.  When we saw that second line on the pregnancy test, or heard the excited words from our mate, we had no idea that it would end this way.  But, somehow, this is the bus we ended up on and this is the ride we (and our partners) take.

Sometimes we may find our partner extremely comforting to us during the time of intense grief.  After all, he or she is likely the person to whom we feel closest and the one who shared the most of the baby experience with us.  Our partner may be great at knowing what we need and being able to provide it much of the time.  Many people do report a sense of feeling closer than ever to their partners after a perinatal loss.

But all of us at some point, in the midst of our own imperfections, pain and sense of overwhelm, run the risk of adding to our partner’s suffering.  Even in the strongest relationships, there are likely to be moments (sometimes many) of disappointment or anger though out the grief process.  These upsets may appear as passing challenges or large crises that cause concern for the couple about their long term commitment.

Sometimes partners injure each other because they don’t know how to react in the midst of this type of life event.  After all, who ever took the prep course on how to lose a baby?  When new to grief, or this type of grief, many people jump to assumptions about what they or their partner should be feeling or doing and are intolerant when the expectations are not met.  It may be a husband who thinks his wife is “making too much” over an early miscarriage. It may be a woman who is angry and hurt that her partner does not want to see pictures of their stillborn son.   The intolerance may be verbally stated or just otherwise implied, leading to distance and pain for them both.

Injury can also occur simply due to depleted resources.  When we are maxed out due to sadness and fatigue (and grief is exhausting), it is harder to do the work of reaching out and connecting with with our partner.  It has been noted by many that grief tends to be a rather self-absorbing experience and you may notice yourself turned inward much of the time. It can be easy to look at the distance between you and your beloved and worry that you are no longer on the same side.

Of course, these two issues just scratch the surface of what can arise in a couple’s life after the loss of a baby, but they are ones that are familiar to most of us who have been in this situation.  Fortunately, there are some things you can do to help yourself and your partner.

What Can Help

Examine Expectations

Rather than jumping to negative assumptions about you or your partner’s reaction to the loss, try to first notice what you’re feeling and thinking.  Be curious about what has come up for you in terms of beliefs about what you or your partner should be doing.  Consider that these assumptions may stem from cultural, gender or personality influences as well as your own history of loss.  Acknowledge and take responsibility for your own bias, remembering that we all have them.

Respect Differences

Unless your partner is exhibiting behavior that you think is dangerous, try to respect that he or she is having an experience different from yours and is entitled to be in that place.  If you can suspend judgements about right or wrong, and work on accepting and acknowledging that you are grieving differently, it can neutralize some of the anxiety and related hurtful reactions.  The truth is, however close or similar you and your partner may be, the two of you are different people who had different experiences with the pregnancy and/or baby as well as the circumstances of the loss.  As a result, you can’t possibly have the exact same grief experience.

Build Bridges

Although it’s important to allow for the space inherent in holding different views and feelings, it’s also important to find ways to meet and connect.  This may be far easier in some moments than others and that’s OK.  Being open to the idea will help you to notice opportunities.  It may help to remember that both of you are going through a painful and confusing time.  You are also both adjusting to a big change in the story of your lives together and may be unsure of how the two of you will be in this new chapter.

You may want to be transparent about your intention to try to connect.  Some couples make a time at the end of the day to briefly check in to say how they are each feeling and what they need.  Other couples work together on a project such as planning a memorial or making something together to honor their baby.  It may be particularly helpful to acknowledge difficult feelings about the loss to your loved one.  I’ve heard many people say they would much rather have their partners disclose their sadness or fear than “be strong” for them.

Prioritize Self-Care

Baby loss and the grief that accompanies it make for a high needs time.   A corresponding high level of self-care is appropriate.  This includes a focus on the basics such as eating, sleeping and avoiding abuse of alcohol and other drugs.  Exercise (as appropriate to your current physical condition), meditation or relaxation exercises may be very useful as well.  Sources of support outside of your partner can also be particularly important.  If no one in your current circle seems like the right person to talk to or you feel that you would benefit from additional support, remember that there are options for in person support groups, online support forums or psychotherapy.

Pain and distance in our primary relationship can feel like another layer of loss.  Living in this time of grief challenges us in ways we may never have anticipated.  It is also a time when couples can grow as they learn how to support themselves and each other in the midst of this crisis.

 

 

 

 

 

 

Smacking Sharks

The ability to be in the present moment is a major component of mental wellness. – Abraham Maslow

Blue ocean underwater sun rays background


I recently spent some time reading aloud to a family member who wasn’t feeling well.  Our selection was Unbroken by Laura Hillenbrand, the true story of an Olympic runner who was in World War II. It’s not the kind of book I usually go for, but I plan to finish it as I’m finding it to be not just a page turner, but pretty darn inspiring.

The part we just finished (spoiler alert) involves the main character, Louie Zamperini, floating in a life raft after his B-24 bomber has crashed with the loss of eight men aboard.  He is one of the three crew members who have survived together on two life rafts.  After being adrift for 27 days, with the men in the throes of both intense starvation and dehydration, a plane appears overhead.  Unfortunately, it’s a Japanese aircraft,  which starts firing at them.  Louie jumps overboard to avoid being shot and the life raft begins to be riddled with bullets.

The area of the ocean where this takes place is infested with sharks, and as Louie enters it, he suddenly becomes the intended object of the next meal.  Weak and underwater, Louie is approached by attacking, open mouthed sharks which he fights off using the information he learned in a survival class (basically to widen his eyes, bare his teeth and bop the sharks on the snout with an open palm).

He goes back and forth between shark bopping and climbing back onto the raft in between the six passes of the plane and six episodes of shooting (plus a dropped bomb that did not explode).   When he climbs back aboard the raft for the last time he finds his two crew mates miraculously unscathed by the shooting.  The three of them manage to save one raft and patch the 48 bullet holes in it while taking turns pumping out water and clubbing the sharks that are now jumping out of the water to get at them.  Altogether a pretty intense series of images…


The story stirred up a lot of thoughts for me, and is currently serving as a marker of what a really bad day can look like.  It made me think, too, about how so many dramatic episodes in life seem to be a mixture of lucky and unlucky events.  Another take on the story could be that it’s a compelling message about not giving up in the middle of a crisis.  And it has definitely crossed my mind that I may want to invest in a survival class.

It also made me think about how in any challenge, no matter how dire or convoluted, we can only face our issues one step at a time.  We can only be where we are right then doing the little piece in front of us.  We can only be right where we are.

Louie had a bunch of things on his mind that day in the ocean and he was full of action, but he wasn’t really multi tasking.  When he was smacking sharks, he was smacking sharks.  Not dealing with starvation, dehydration, avoiding bullets, fixing the boat or trying to float to land.  He wasn’t even breathing.

If Maslow was right about the ability to live in the present moment being a component of mental wellness, and if all of those writers, meditators and therapists preaching mindfulness are also on to something, then our moment, our now, seems a bit more sacred.   What we are doing right now is what we need to be doing fully.  And all the moments coming will benefit from engagement with the one we’re having with now.

More aspirational than realistic as a way to be all the time?  Heck, yeah.  And what’s wrong with that?

I was pretty anxious during my last pregnancy, which occured after my two losses.  But I remember a point where I really started to appreciate that there were very few things in the pregnancy that were under my control.  I could try to eat well, take my vitamins, go to my doctor appointments and generally try to live a safe and pleasant life.   And that very short and humble list was the total extent of my control over the experience.

And sometimes, not all of the time, I felt the freedom of that humble list.  I could eat and think about eating (way too many bagels for some reason), take my vitamins and so on and those actions had meaning and purpose.  The rest of the time I could try to take up my now, whether that moment was about acknowledging and living with a moment of fear (which always passes eventually) or enjoying a moment of peace or hope.  Just like in meditation or any type of mindfulness, I didn’t stay in this place.  My mind would race away and I would have to circle back, but it helped.  It helped a lot.

In times of uncertainty, (which, realistically, is always) this is the only moment we have.  If we’re in a tough spot, breaking it down is likely to help us get through it.  If we’re in a great spot, it’s probably worth taking in.  Yes, we’re going to sleep through and space out through much of our lives.  But it just might help to notice that we can also jump in and roll around in a given moment.  Your right now experience may feel like a challenge, a gift, or pretty inconsequential, but by noticing it, you might live it a little more deeply.

 

 

 

 

 

 

l