Monthly Archives: March 2015

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


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“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.