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Survival Tips for PPD moms who experienced a past sexual trauma

Here is a recent blog post by Postpartum Progress written by Karen Morelli, LPC. She shares tips for new mom’s surviving past sexual trauma. As a clinician that works with survivors of trauma everyday, I found this piece important and one that is often not shared. See below.

“Childhood sexual abuse and a woman’s subsequent reproductive years, including menstruation, pregnancy, birth and ongoing sexuality, occurs years or even decades apart. Yet, in my clinical practice, I have found these issues to be intertwined. Sexual themes resonate with… a woman on multiple levels: within her body, her emotions and her psychology. And distress from childhood sexual abuse can resurface during the emotionally and hormonally charged time of pregnancy and postpartum. What research exists, finds that women who suffered from childhood sexual abuse have an elevated risk of postpartum depression, besides other physical and emotional symptoms. Related triggers around reproductive health:

During Pregnancy Body-based feelings in pregnancy can be re-triggering to a woman who has deep, somatic memories of childhood sexual abuse. Simple things such as the position of your body during vaginal exams can bring back emotional memories of past abuse. The baby moving inside your body might cause intense joy, but might also create an underlying uneasiness.

During Birth Childbirth is an intense experience; a time of hormonal, physical and emotional exertion. Early trauma can be triggered by a particular scent for example, or a body position. If you feel powerless, not heard, or disregarded by your healthcare providers during childbirth, it can activate the symptoms of post-traumatic stress and flashbacks of your past trauma.

During Postpartum There are many physical, emotional and psychological factors feeding your emotional health during this time. And it’s true that a pre-existing personal depressive or anxiety disorder, or pre-existing PTSD, sets your body up for another episode postpartum. Intense physical and hormonal changes, plus adjusting to a new lifestyle caring for an infant is physically and emotionally challenging. Feelings of frustration emerge as you adjust your schedule to accommodate your baby. The endless touching may leave you feeling like your body isn’t your own anymore. Breastfeeding may feel triggering to some, as it too may cause confusing sexual feelings.

So what can you do to proactively manage your mental health during these phases of motherhood? First, I want you to know that your childhood sexual abusive does NOT define you. Your past does NOT have to be your destiny. With perseverance, you can move beyond being a survivor towards thriving and blooming beautifully. It’s not an easy task, but your self-esteem is worth the fight! Managing the effects of an abusive childhood is an on-going deeply personal experience. It’s honorable life work, and highly individualized. As you move along your healing path, you’ll choose what’s right for you.

Tips to help enhance your experience of pregnancy, birth and postpartum:

1.Recognize that post-traumatic stress is a real disorder, not some fake diagnosis.

2.Practice Self-Love. Self-love is not just an empty clich , it’s something worth fighting for. Allow yourself to rest and be gentle with yourself during all three stages of motherhood.

3.Try to make time to get help with a licensed mental health professional before pregnancy. It’s best to put in your emotional work before starting a family, but it can also be done if you are already pregnant or postpartum (see below.) It’s never too late to begin.

4.Face your fears and past, at your own pace, in a safe and professional environment.

5.Work with a gynecologist/obstetrics/midwifery provider with whom you feel comfortable enough to discuss your history of trauma. Investigate the hospital or birth center where your provider practices to make sure it’s the right fit for you. If your provider or institution don’t meet your needs, you are empowered to find another. It’s important to advocate for your own health care.

6.Find an experienced childbirth educator who is accepting of your personal choices. Birthing and breastfeeding classes really do help on an emotional level as well.

7.Remember that birth is an unpredictable experience. If your birth experience doesn’t follow your birth plan, you can still feel good about it. You are not less of a woman or mother, no matter how your birth happens.

8.Honor the achievement of childbirth and motherhood. You are growing a life! That is a huge accomplishment.

9.Understand that your hormonal balance takes at least three months after birth to come back to pre-pregnancy levels.

10.Honor and protect yourself during ”the fourth trimester” and beyond, as your body shift towards balance:

  • Rest; develop the mindset of being, not doing.
  • Practice good nutrition with whole foods and good supplements.
  • Get help. If you can afford it, set up some time with a postpartum doula or a baby nurse so you can rest. Enlist the help of family or friends. You don’t have to do this on your own.
  • Don’t underestimate the power of sleep. Work out a sleep plan. Even if you are breastfeeding, don’t be the only one getting up to feed the baby.
  • Practice mindfulness and relaxation to counteract the inevitable challenges of caring for a newborn and the emotional change of identity in motherhood
  • Nurture yourself with complementary care. Safe touch such as shiatsu and acupuncture can re-balance your body and mind.Expect some emotional ups and downs and realize these are normal.
  • Social support is important. Women who ”Tend and Befriend” in real life and online feel supported.
  • If you feel very sad or anxious, there is a lot of professional help available to you. You are not less of a mother if you see a doctor or therapist. Taking care of you makes you a better mother. A beautiful book about healing from child sexual abuse that I highly recommend is ”A River of Forgetting” by Jane Rowan.
  • If you had the experience of childhood sexual abuse, know that post-traumatic growth is possible. Don’t wait to honor yourself by doing the emotional work. You can ask for and get help. You and your family are worth it. And know that you are not alone.

-Karen Morelli,LPC

Reference: Perez-Fuentes, G., Olfson, M., Villegas, L., Morcillo, C., Wang, S. & Blanco, C., (2013). Prevalence and correlates of child sexual abuse: a national study. Comprehensive Psychiatry, 5(1), 16-27.

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Surviving and Enjoying the Holidays

As the Holidays are fast approaching, I have spent much of my time during sessions preparing clients for visiting and enjoying their time with their families and loved ones. Most vacations away visiting families or staying home are wonderful and full of long lasting positive memories. Sometimes, this is not the case with all families or all trips. One idea to help navigate through potential troubled waters, is to create a mini traveling survivlal kit that will help soften some of the intense feelings that occur after a family trigger. Trauma Expert, Janine Fischer suggests this with people who are at risk for self harm, but I have found that this idea helps many people cope in all situations. We are always packing for EVERYTHING–why not “pack” a kit that will help you cope with potential family triggers. Triggers can occur in any sensory experience: sight, taste, smell and auditory.

The contents of the kit depends on YOU and the details surrounding the trip. To prepare, you must think about potential pit falls and triggers, as well as, the events that you really want to ENJOY! With this in mind, pay attention to how you are feeling when thinking of the triggers — how intense are they? where are you feeling them in your body? Now — what are some things that might help you cope IF this situation occurs during your home holiday or your vacation away. Some suggestions are: exercise, going to the movies, listening to a great song list, knitting/sewing, reading a book that is pleasurable, calling/texting a friend…. . Make list and practice preparing to use it. You can literally create a box to bring or even something in a separate bag that would also include your favorite quote, stones or other “grounding” objects.

When faced with difficult family situations, this survival kit gives you a plan to help control feelings that can be overwhelming and can cause you to feel flooded. Most importantly, the goal is to ENJOY the events that are important to you and not remain STUCK in the emotional storm. Hope this tip helps you in enjoy your holiday.

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Time Outs for Everyone

As a parent of three young children, the days of time outs are not far behind me. What I find interesting is how this behavioral tactic is so useful for children and adults of all ages. When Time Outs are used with self-soothing techniques (ways to calm yourself down), the road to compromise with your offending partner is not so bumpy! But how do you know when to take a Time Out during a disagreement?

John Gottman talks about this important break in his book ”And Baby Makes Three”. The first important step is identifying what you are feeling and if you are becoming flooded. Yes – just like your basement flooding or sadly the Titanic, but it happens more quickly and is felt differently across gender lines.

For some people they may feel:

  • Knots in their stomachs
  • Jaw tightening
  • Changes in their breathing patterns
  • Freezing/or difficulty moving

Gottman describes this as a tidal wave of physiological sensations: called Diffuse Physiological Arousal: DPA. When we are in this state, our reasoning, hearing, and rational self are altered. Thus the fight or flight sensation is activated. According to Gottman, we must then know to take a break and calm down in order to effectively navigate (and compromise) within the argument. If not, we end of saying and doing things that we often regret later. Sound familiar?

Gottman believes that we need to first understand and recognize the signs of DPA so that it does not suck us into a vortex of an alarmist state ’ ready and mobilized for action! Taking this break has to happen before the flooding. It is also important to indicate when you will resume talking about the issue at hand. It is recommended at least a half an hour, but not more than one day.

During that time, our systems have calmed down and we will be better able to compromise with our partner, child, and co ’worker. The details of the time out (the identified mutually agreed upon sign that a break is needed, for how long and can we commit to this ritual) with a partner / child can be discussed during calm times before a heated discussion.

With outside people, one can simply say ”it seems as though we don’t agree, why don’t we talk about this situation later when we can have some time to think about it?” .

Don’t forget to calm yourself down when the time out is happening. Some clients of mine write, other listen to music, exercise, and take deep breathes. This part of the ritual must happen or you won’t be ready or able to do the next big step: compromise!

Try this method out! You will be surprised how well it works.

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Best Way to Communicate Issues

Dr. John Gottman’s describes one way to communicate difficult feelings within a couple is by utilizing what he calls the slow start up. I have found the process also helpful within families, with children, in the workplace, and amongst friends. Gottman believes it is all about the way we begin verbalizing our feelings and needs.

Now we all have found ourselves in situations where we approach our partners “guns” firing in all directions. Usually the person responds defensively with criticism, real contempt, defensiveness or they stonewall us. I think we can all recall where we have been on both sides of this type of argument.

I support Gottmans’s belief that if you begin communicating your needs in a “soft” way the message is better received. Describe the situation neutrally, using “I” statements and state what we need — not what we are NOT getting. That is like stab in the heart.

So: Say what you are feeling

Describe the problem neutrally — but don’t blame the other person

Say what you need

Ready to try it out?