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Birth trauma refers to a distressing emotional or physical experience that can occur during childbirth. It is important to note that birth trauma extends beyond the events that occurred during labor and delivery. It also encompasses the feelings and emotions experienced by the mother afterward. Approximately one third of women go through such trauma. It is crucial to recognize that the perception of trauma is subjective and should be defined by the woman who has experienced it.
The Roots of Birth Trauma 1. The experience of traumatic birth is subjective. Each woman’s childbirth experience is unique, and what may be traumatic for one person may not have the same impact on another. Below, I am sharing a few potential events that can act as triggers for birth trauma: Past traumatic experiences: Similar to how pregnancy can trigger past traumas (read my article about it here), invasive or non-consensual interventions during or after labor can make the birth experience traumatic for us.
2. Complications or emergency situations during birth: Lengthy or intensely painful labor, emergency interventions, inadequate pain relief, and experiencing injury during labor.
3. Poor postnatal care and lack of a healthy support system.
4. Postpartum complications: This includes issues like hemorrhage (excessive bleeding during or after childbirth), tears, or severe physical pain. Additionally, the birth of a baby with a disability resulting from a traumatic birth, the experience of stillbirth, or the need for your baby to stay in neonatal intensive care.
5. Healthcare system dynamics: The current health system often portrays patients as passive recipients, with healthcare practitioners holding the authority. This dynamic not only fosters a sense of control over women, but also perpetuates the acceptance of possible mistreatment.
6. Unnecessary and unwanted medical interventions: For example, undergoing a C-section to speed up the birth when it is unnecessary, or being manipulated into agreeing to certain interventions or procedures.
7. Staff attitudes during and after labor, for example, I have had numerous clients who were not traumatized by the birth itself, but by their hospital stay in the days following childbirth. Unfortunately, some staff members made them feel inadequate and instead of providing support with baby care and breastfeeding, they passed judgment. It’s important to note that this is not the case worldwide. In countries where the practice of “sitting month” is observed (as discussed in this article), women often have a different experience and receive more positive support after giving birth.
8. Lack of communication, such as not explaining what is happening during interventions. This experience of feeling unheard and disrespected by the medical team leaves them feeling unsupported throughout the birthing process. Additionally, there have been instances where women’s wishes were ignored by care providers.
9. Objectification: Some women have reported their childbirth experiences being treated as teaching moments for hospital staff without their consent. Such dehumanizing experiences can exacerbate the trauma associated with childbirth. Personally, I had a similar experience where I was not fully informed about the presence of a learning doctor during my birth. Although I felt protected by my husband and doula, it would have been nice to understand why he was just standing there.
10. Disregard for women’s bodily experiences like ignoring her pain and sending her home, minimizing their beliefs of being in labor or having the urge to push.
11. Expectation-reality gap: When our own, or society’s expectations of how our birth should look like, don’t align with the actual experience. For example, unplanned cesarean sections or the use of forceps, which may be necessary for medical reasons, can evoke feelings of powerlessness and violation.
12. Comparison among mothers regarding birth and the hierarchy of birth: Have you also felt this? I’m curious to know. There can be a subtle comparison among mothers and a hierarchy of birth experiences. Using language like ‘natural’ versus ‘unnatural’ can imply a hierarchy, which I don’t believe in. It’s important to acknowledge the diversity of childbirth experiences.
Am I experiencing birth trauma? Women experiencing psychological birth trauma may exhibit various symptoms that can significantly impact their well-being. When any trauma overwhelms our nervous system, it manifests itself in experience symptoms of shutting down, such as dissociation, avoidance, numbness, or depression. Or in symptoms of hyperarousal, including increased vigilance and anxiety. Let’s explore some symptoms manifestation related to the traumatic experience of childbirth:
Hyperarousal and/or Reactivity: You may feel constantly on edge, easily startled, or have a heightened sense of vigilance. Difficulties in sleeping, feeling tense, or experiencing angry outbursts can occur. You might find yourself constantly being on guard, anticipating potential threats or danger, and having ruminating thoughts.
Numbness or detachment: You may feel emotionally numb or detached from your surroundings as a way to cope with the traumatic memories. It is not uncommon to avoid anything that reminds you of the traumatic event. This can include discussions about childbirth, medical settings or procedures, or even distancing yourself from friends, family and baby.
Psychological trauma often manifests in physical symptoms as well. You may experience changes in appetite, chronic fatigue, or unexplained health issues that cannot be attributed to a specific medical condition. It’s important to remember that after giving birth, some of these symptoms can be considered normal adjustments to the postpartum period. However, it is crucial to evaluate each person individually to determine if these physical symptoms are related to the trauma.
Flashbacks: You may re-experience the traumatic event through intrusive thoughts, vivid images, or nightmares. Certain triggers, such as visiting the hospital, hearing a baby cry, or even subsequent pregnancies or deliveries, can bring back traumatic memories of your birth experience.
Feelings of guilt, shame, or anger: It is not uncommon for women to experience intense feelings of guilt, shame, or anger related to their childbirth experience. You may blame yourself for not being able to meet certain expectations. It’s important to recognize that feelings of guilt and shame are often present in traumatic experiences. If you are experiencing these emotions, it can be an indication that you may be suffering from birth trauma.
If you find yourself experiencing postpartum depression, anxiety (article), or frequent angry outbursts following childbirth, it could be a sign that you have been through a traumatic birth.
How can we protect a mother from birth trauma? Birth trauma cannot always be prevented, but there are steps that can be taken to reduce the risk. As you prepare for the birth, it is important to not only focus on the technical aspects but also on emotional preparation.
Take the time to reflect on your expectations and consider how you might feel if they are not met. Explore your feelings regarding possible interventions and discuss these questions with your partner, a friend, or a therapist. Engaging in stress-reducing techniques and creating a birth plan can also help you feel more prepared and empowered.
Creating a safe and supportive environment for yourself during childbirth is important. Remember, you are the most important person in this process. If possible, ensure that your birthing partner is prepared as well, serving as a bridge between you and the medical staff. Your partner can act as your voice and protector, safeguarding your space and advocating for your needs. If you and your partner are unsure or would like additional support, consider hiring a doula. A doula can provide continuous emotional and physical support throughout the birthing experience.
In addition to individual preparation, it is crucial for medical professionals to gain better understanding (and training) regarding an emotional-wellbeing of the mother and how important their role is in preventing birth trauma.
The responsibility lies not only with healthcare providers, but also with society as a whole, as the focus tends to be more on the newborn than the mother’s (mental) health. It is essential to address these systemic issues and work towards a patient-centered approach that prioritizes active participation, effective communication, and respectful treatment within the healthcare setting.
By taking these steps and advocating for yourself, you can help create a more supportive and empowering birthing experience. Remember, you have the right to be heard, respected, and actively involved in the decisions regarding your care.
In conclusion… Birth trauma can have profound effects on women’s emotional well-being after childbirth. Unfortunately, the stigma surrounding birth trauma often leads to underdiagnosis and limited discussion of these experiences. Many women feel uncomfortable sharing their birth trauma, fearing judgment or the perception of being inadequate mothers.
By working with a healthcare professional or therapist who specializes in trauma, you can receive guidance and support in navigating the healing process. Remember, you are not alone in your experiences, and seeking help is a sign of strength.
Self-gaslighting is a phenomenon in which individuals manipulate their own thoughts and feelings, causing them to doubt their own perception of reality. This internal process leads to a relentless questioning of one’s thoughts, beliefs, feelings, and intuition, often resulting in self-doubt and self-criticism. Those who engage in self-gaslighting may heavily rely on external validation or feedback from others to gauge their worth and make decisions. It is important to distinguish self-gaslighting from gaslighting, the later involves another person manipulating someone’s perception of reality to the extent that they begin questioning their own sanity and memory.
Why does it come to self-gaslighting? Self-gaslighting is a trauma response that occurs due to abusive relationships. Often, individuals who have been gaslighted by a parent or partner find themselves engaging in self-gaslighting. I have also witnessed self-gaslighting in clients who experienced neglect during their childhood. It is during these situations that individuals start convincing themselves that they don’t require anything or that having wants is somehow wrong. When someone constantly disregards your needs and desires, it can lead to the development of defense mechanisms as a means of survival in abusive circumstances. Through my observations, I have identified several defense mechanisms commonly associated with self-gaslighting:
Minimization is a defense mechanism where individuals undermine or diminish the significance or importance of their own thoughts, feelings, or actions. It often manifests in phrases such as “It’s not that bad” or “I’ve seen others in worse relationships.”
People-pleasing (fawn respond) refers to the tendency of individuals to prioritize the desires and preferences of others over their own needs and wants. This behavioral trait is often rooted in the strong desire to be liked or accepted, as well as going to great lengths to avoid upsetting others or causing any form of disagreement. They may find themselves constantly seeking validation and approval from those around them, going as far as sacrificing their own well-being and personal boundaries in the process.
Denial is a defense mechanism employed to shield oneself from confronting painful or distressing thoughts, emotions, or realities. It manifests as the rejection of the existence of a specific situation, event, or truth, typically with the aim of preserving one’s self-image or evading emotional discomfort.
Rationalization is a defense mechanism where individuals justify or explain their or others thoughts, feelings, or behaviors in a manner that alleviates discomfort or conflict. This defense mechanism involves coming up with different reasons or excuses for one’s actions or beliefs. For instance, he behaves this way because he had an abusive childhood.
What are we protecting ourselves from? Self-gaslighting serves as a way to shield ourselves from the pain we carry within. It often stems from a deep desire to be accepted or, conversely, a fear of rejection. This fear of rejection may originate from experiences of frequent rejection during childhood. Whether it was directed at our emotions, our thought processes, or even our very presence, we may have felt unwanted and burdensome to our parents. Consequently, we develop defense mechanisms as a temporary means of protecting ourselves from potential rejection. Paradoxically, these defense mechanisms can manifest as self-rejection, as we deny our own feelings, thoughts, desires, and instincts. What lies beneath this fear of rejection? The fear of being rejected can stem from a fundamental belief that we are not good enough and that we do not deserve better.
Also, in self-gaslighting there are two sides In this article, I am focusing on individuals who find themselves in abusive relationships and subsequently resort to self-gaslighting. However, it is important to note that the abusers themselves can also engage in self-gaslighting. We convince ourselves that our abusive behaviors are not our fault, placing the blame on the other person. Our energy becomes centered on criticizing and correcting our partner. We justify our abusive actions by finding excuses or attributing them to external factors, such as saying, “Well, if he hadn’t forgotten to call me, I wouldn’t have lost control.” In essence, we shift responsibility onto the other person, downplay our negative actions, or make justifications- using the same defense mechanisms mentioned above.
Signs of self-gaslighting Second-guessing your feelings involves downplaying or doubting your own emotions. It often manifests in self-talk such as “I’m too sensitive,” “I’m being overly dramatic,” or “I must be crazy for feeling this way, everyone else sees things differently.” You invalidate your own emotions and convince yourself that your feelings are not valid or justified. By comparing your reactions to others and assuming that their perspective is the “correct” one, you undermine your own emotional experiences.
Rationalizing toxic behavior involves making excuses for someone’s harmful actions or shifting blame onto yourself for the way they treat you. It entails dismissing your own feelings and perceptions in favor of the other person’s perspective. For example, saying things like, “I’m sure they didn’t mean to hurt me, it’s all in my head.”
Questioning your memories involves doubting your ability to recall specific events and, in some cases, even creating false memories to avoid confronting uncomfortable truths. You undermine your own recollections and manipulate your perception of reality.
Constantly apologizing involves saying sorry for things that are not your fault or within your control. I notice this tendency in my female clients, who often apologize excessively. For instance, apologizing for crying, expressing emotions, or simply apologizing without a specific reason. It is a common word used in everyday conversations. This behavior can stem from various factors, including societal expectations, cultural conditioning, and a desire to maintain harmony or avoid conflict. Apologizing excessively may be an attempt to please others, prevent disapproval, or alleviate feelings of guilt or shame.
Avoiding conflict involves conforming to other people’s opinions or beliefs, even if they contradict your own. Over time, this behavior can lead to questioning your own thoughts and values. By prioritizing harmony and avoiding disagreements, you may suppress your own authentic voice and sacrifice your individuality. This can result in feelings of inner conflict and a diminished sense of self.
Downplaying your achievements involves dismissing your own hard work, dedication, and perseverance. It manifests as a lack of belief in your abilities and talents. Additionally, comparing yourself to others is a common pattern. You undermine the value of your own accomplishments and diminish the recognition you deserve. This can stem from various factors, such as imposter syndrome, fear of being perceived as arrogant, or setting excessively high standards for yourself.
Downplaying your needs and wants involves considering other people’s needs as more important than your own. You may feel guilty when setting boundaries or saying no to others. Additionally, you may struggle to express your needs or even have difficulty identifying what you want.
Perceiving normal behavior as something exceptional involves seeing regular or expected actions within a relationship as extraordinary or noteworthy. When someone is in an abusive relationship, they may see basic kindness or decency as special because they are used to being mistreated all the time. This can cause them to have a distorted perception of what is normal or expected in a healthy relationship.
What to expect when we are working through self-gaslighting? Because self-gaslighting can run deep and is a trauma response, it is likely beneficial to seek support from a trauma-informed professional. What can you expect during the process of working on yourself?
Self-doubt is indeed a common experience for clients who engage in self-gaslighting. They frequently question their decisions, feelings, and thoughts, even when the choices seem clear to an outsider. As a professional, it is important for me to refrain from pushing them in any specific direction. Instead, I prioritize helping them learn to distinguish between their own authentic feelings and desires versus the expectations or desires imposed upon them by others. One technique I use is guiding clients to tune into their bodily sensations when making decisions. I encourage them to ask themselves how a particular decision feels in their body. We also explore the alternative scenario of not taking a certain decision and examine how that feels in their body. This exercise, known as sense checking, is valuable in developing self-awareness. Initially, they may not notice significant differences, but with consistent practice, they gradually learn to discern their true feelings. It is crucial to recognize that if someone has experienced manipulation, their sense of reality may be clouded, leading to heightened self-doubt. Working through these doubts and learning to trust one’s own perceptions and experiences is an essential aspect of the healing process.
Also, it is important to be aware that it is common to experience feelings of uncertainty. The objective is not to achieve 100% certainty. Instead, it can be helpful to “cement” certain decisions as a starting point. For instance, acknowledging preferences such as “I like pasta,” provides a solid steppingstone from which to build upon. When everything feels uncertain and fluid, having these steppingstones can offer stability amidst confusion. By creating multiple steppingstones, you can establish a stronger sense of stability. As you progress and gain more stability, you can look back and sense check if the decisions you have cemented still align with your current needs and desires.Still liking pasta?
It’s important to acknowledge that not every decision will feel completely certain or clear-cut. In fact, some decisions may have very close 50-50 split. With the information available, it may be challenging to come to a definitive conclusion. It is common for individuals to get stuck in these types of decisions, fearing the potential regret. However, it’s crucial to recognize that experiencing regret is a natural part of life. It is impossible to go through life without any regrets. Rather than focusing solely on avoiding regret, it is more beneficial to learn how to process and let go of regrets when they arise.
Initially, it can be challenging to identify our own wants and needs, leading to a sense of confusion. It becomes important to constantly ask ourselves, “What do I want?” and pay attention to how our body reacts in different situations. Is our motivation driven by our own desires or influenced by the expectations of others? As we gain a better understanding of our wants and needs, we may encounter feelings of guilt or fear of rejection when expressing them. Guilt and/or shame is a complex emotion that often leads us to prioritize the needs of others over our own. It can be uncomfortable to sit with this guilt and not act upon it. However, it is worth the challenge. Learning to do what we want, even in the face of guilt, is an important step towards self-empowerment and personal growth.