The following is from prior Great Expectations blogger, Heather Maloney. In this post, she details a very personal experience of experiencing and healing from PTSD and anxiety that came on during pregnancy and continued throughout postpartum.
I remember when I noticed there might be a problem. It was in the first month after my first child was born. Someone dropped something in the kitchen, my head snapped up, and I noticed a wrinkle in a bath towel hanging in front of me. I could feel my brain connect the sound and sight and say "Oooh, that means something very bad is about to happen." Since obviously nothing did, I shrugged it off.
It was 2013, and at the time there was something missing in the resources I had available to me regarding PTSD. In my doula training, I had gained an awareness of certain risk factors, like types of trauma, sexual abuse, a complicated or risky birth, poor treatment by a care provider, etc. But I had experienced none of those things.
What I did have were nightmares--really, really graphic ones. Difficulty maintaining conversations, or calling people--even myself--by name. A certain dread that would descend around sunset. Persistent thoughts of death and suffering, to the point that I didn't like to drive the car, and wouldn't dress my baby in my favorite outfits, because I didn't want that to be what I found her dead in. I also had an infant that would scream if set down, never slept more than an hour straight, and a husband who was struggling to figure out what he wanted in life. As opposed to trauma within a perinatal setting, I experienced the perinatal period within the already troubled terrain of complex or developmental trauma caused by experiences in childhood and the years immediately before pregnancy.
My family and I muddled through the next two years; it didn't get better. We moved four times, and went through periods of changing jobs and unsteady employment. I would make my own shampoo, do the laundry by hand, and agonize over how to get medicine when my daughter was sick. When my husband finally settled into a career, it was one that would keep him away from home most of the time. Functionally, I was a single parent of two.
I was seven months pregnant with our second child when it all exploded. I woke up one night in a different world. I could see the space around me spinning, shrinking. I couldn't breathe. At 2 am, I texted my midwife: "What is this? Indigestion? A nutritional deficiency?" The only response she had for me was a few kind words and a generic article on anxiety. Over the next few months, the panic continued. Once finally asleep, I would wake up to floods of dread and sit out the night with my eyes laser locked on the neighbors' porch light. I couldn't focus enough to watch TV or read. I couldn't be in the house. I was suffocating. I would put my toddler in her stroller and waddle around between the neighborhood stores for hours in the freezing cold and smog.
With my first child, I labored for four hours. With the second, it was four days. I would panic when the contractions became regular, and fall asleep until they slowed again. I finally requested to have my water broken just to get it over with. This was at home with a midwife; I don't know what would have happened in a hospital. Fortunately, Baby #2 was safe and well, and slept better than her older sister. Perhaps there was hope for the future.
It was around this time that I finally made an appointment with a therapist and the possibility of trauma was mentioned. It was a word I carelessly batted about during my first pregnancy. Now I would come to understand it in an entirely different way.
In my case, it's a fuzzy, almost numb, or nauseous sensation. Time goes either very fast or slowly. Some things are crystal clear and in my face, while others are blurry and won't stick in my head no matter how much I need them to. My speech is broken. My body moves slowly. Most of all it's a feeling of wrongness, shame, and fear of some unknown disaster. It's painful in a way that almost can't be described, that to others is easy to dismiss because it doesn't seem that awful. It's an unspeakable badness. I call these my "blood on the walls" days.
It's been four years since that time, and while some symptoms still linger, I'm pleased to be able to tell you that I feel better now than I ever have in my life. That suffering has been the catalyst for a great deal of personal growth.
During the panic attacks, I would walk the house and make promises to myself to do whatever it seemed I needed to feel more safe and comfortable. This commitment became the basis for a growing relationship with the self I had mistrusted and neglected for so long. After taking some time to regain a bit of equilibrium after giving birth, I invested a lot of effort in studying the topic of trauma, understanding many of the pieces of the brain and body that are affected and how they work together. I've tried a number of treatments and can attest to what I've personally found most powerful. Let me list them.
Focus on Integration
This is the magic behind everything else I'm going to share. In a way, PTSD is an illness of fragmented experience. Memories, thoughts, feelings, and the sensations of the body get broken up, confused, and out of proportion, and we spend a good deal of time using cheap behaviors trying to ignore it all and get through the day.
The fix is relatively simple, though it takes some getting used to. When you notice a thought, look for any emotion that comes with it. When you feel an emotion, identify where you sense it in your body. See if any memories, thoughts, or feelings follow that sensation, and so on. Following the impact these factors have on one other strengthens them and their combined relationship. When they are well aligned, we feel clear, calm, and full of energy. Below are some ideas and activities that can be used to work on each or all of the parts.
The one caveat to any of the following activities is that you need to trust yourself to know when you've had enough. Sometimes you are ready to run ahead. Sometimes you need a break to process what has already come up. Sometimes it gets to be too much, and you need some professional support to get yourself back on track. Better yet, get professional support in place before taking on this new adventure. These practices are helpful as long as you feel aware and in control, and able to stop anytime or ask for whatever you might need before continuing.
Telling the Story
At first, I just talked to my husband. I talked about everything from little annoyances to the really big hurts. I poured out all the fear, self pity, all the anger and resentment. If he wasn't available, I wrote out long texts, or notes on my phone. Whenever I faced the same frustration, I told the story again. Eventually, the tide of words became a narrative pattern. A few tellings more, and the next thing I knew, the answer I needed would waltz right out of my own mouth!
I know it's not always that you have someone willing or able to do that much empathetic listening. Fortunately, "talk therapy" is just one way to take the energy that is trapped in your head and move it into a living space and flow of time, where it becomes easier to gain insight and make changes.
Other options are:
Tell your story in different mediums and see what you find there. Then, you might try making changes to the narrative by introducing a positive idea, object, or person. How does this change the potential meaning for you now?
Exercise for the Nervous System
Part of my journey has been discovering that I am not "traumatized" as much as I am trauma-prone. I have a highly sensitive nervous system and some sensory integration issues, which means I get easily overwhelmed and disregulated when under stress. Each of these discoveries had come with new ideas for how I can improve my symptoms, and fulfill my commitment to care for myself.
The nervous system is the force behind the wild reactions we can have to "triggers". As easy as it is to feel betrayed by this hijacker that chooses our reaction before we have time for conscious thought, it also provides a route to treating many of the effects of trauma without having to constantly talk about difficult subjects or exhaust ourselves in trying to fix our thinking.
A local family support center near me has been offering sessions of Trauma Sensitive Yoga (TSY). I cried my way through the first few classes, but this was the first time I noticed a treatment make a significant difference in my well being. I could feel my body getting stronger. I was more connected to the resources in and outside of me. Suddenly, I didn't see myself as fragile anymore. TSY is also a great exercise in autonomy, one of the things most likely to be paralyzed by trauma. Feel free to modify or ignore certain poses. One woman would spend a large part of the class lying on her mat wrapped in a blanket. For her, it was a time to practice individuation.
Since those sessions, I've discovered how many exercise programs are found to have a positive effect on nervous system function. I also love:
Making Friends with Emotions
Here and there, as I've read, I've caught some tiny thing someone mentions in passing and thought, "WHY do they not teach this stuff somewhere?!?" Who knew anger was simply a signal for needed change and greater personal responsibility? That we are judgmental and dismissive of things and people when we feel unsafe or insecure?
It can be tricky to get the knack of catching what you're feeling long enough to put a name to it, especially if you've gotten used to hiding such things, but when you do, you've turned that supposed liability into a valuable resource of information. It can also be intimidating to tackle big emotions because we are afraid of getting lost in them. I'm going to call this one out as a cultural myth. More often, we get lost in unhealthy patterns of avoiding emotions, which eventually turn into addictions. Mine, if you'd like to know, are sugar and the internet.
At some point in this process, it occurred to me that I had some "mourning" to do. Whether loss, sadness, anger, or fear, I simply took the time to listen and let be, believing that it would begin to change and eventually pass. Within a couple of years, most of the distress and overwhelm that had plagued me all my life were gone. What hasn't, I know I'll eventually get a handle on. Here's where I learned some other helpful tricks:
- The Dance of Anger, and other books by Harriet Lerner
- Managing Emotional Mayhem and Easy to Love, Difficult to Discipline, by Dr. Becky A. Bailey (the brilliance here goes far beyond parenting, but it helps with that, too)
- Peacemakers card game from Generation Mindful
- HeartMath
Group Therapy
When I decided to try group therapy, I wasn't sure it was my cup of tea, but it wasn't long before I noticed a strong, positive impact. The main benefit of a group setting is that it provides a regular opportunity to practice compassion and coregulation. What one feels, we all feel to some degree, and learn to manage as we slowly open up our thoughts and questions, and see them met with genuine caring and support from those around us. We are heard and understood, and accepted even as we face some of the darkest pieces of our experience. After that, it's difficult to feel as lonely or ashamed.
Not able to make that work right now? There's plenty you can do on your own or with someone close to you. Coregulation is something we do instinctively, and ideally, looks a bit like this:
When expressing distress, you find
a trusted friend or loved one.
Encouraging mindfulness by inviting attention
to the experience of the body,
the naming of emotions,
awareness of the present moment.
The power to think, feel, sense, choose, and accept what comes,
and the power to seek and receive connection and support.
If you're on your own at the moment, you can modify that process into a type of loving-kindness meditation. Imagine seeking and receiving this kind of comfort from someone who genuinely cares for you. Imagine offering it to someone else. Or give it to yourself. No one else will ever understand how to help you better than you do.
You could also learn about Attachment Theory.
Or, read any book by Brene Brown or Kristin Neff.
Building Skills
This section is much more individual, but I'll give a couple of examples . I recently got a CPR certification for my new job. After it was finished, I felt much less intimidated by the thought of facing a medical emergency. I had a plan I knew I could follow. That confidence would have saved me at least half of the unbearable anxiety of the last three to six years, dreaming of drownings and terrible falls or waking up convinced my baby had stopped breathing.
Secondly, becoming familiar with the patterns of narcissistic abuse has aided me in letting go of a good deal of pain and confusion over the past, and becoming my own champion in current and future relationships, of all levels. I'm no longer so afraid of being victimized by the people around me because I know how to protect myself. I can make choices. I can disagree. I can change my mind. I can make mistakes. I can take responsibility for only those things that are mine.
This is also the category into which I would put Cognitive Behavioral and similar therapies. For me, they were not the best FIRST choice, and good way to keep moving forward after building a higher level of tolerance.
Managing Fatigue
Perhaps you're stuck in the panic phase -- it's all too much to think of and you don't have the energy to add in anything new. I remember being so tired I thought I might quit breathing. Sleeplessness is one of my biggest triggers, to the point that I still get dizzy when I read sleep books, and often can tell how exhausted I am by the intensity of my dreams.
Everyone seems to know about sleep hygiene these days, but no amount of that will make the difference if you're too upset to sleep, or keep you from being woken by a small child in the night. These are the field-tested ways that keep me going when I'm low on rest, while improving my ability to sleep a regular schedule without a chemical aid.
Yoga Nidra. After hearing about this book, I knew I had to try it out. I emerged better rested than after actual sleep. I infinitely prefer this to daytime napping. It's also great before bedtime. I mostly use guided tracks on Insight Timer.
Sunbathing. I was floored when I heard a presentation on the effects of sunshine on the body. Did you know that the water in your cells holds an electrical charge when lit by the sun? You are literally filling yourself with energy, and all you have to do is soak it in. Best when done at solar noon and/or first thing in the morning.
Respite care. The family support center I mentioned above also cares for children under twelve at a scheduled time each week, for about a six month period. It took a while to get through the wait list, but it was absolutely worth it. The workers are well trained, and provide activities to help children build social-emotional skills I only wish I'd had at their age. More recently, I found a local gym and applied to work part-time in their daycare, in exchange for the cost of a membership and a reduced rate for childcare. This allows me some time to myself, to swim, walk, take a class, do some of the exercises listed above, or just sit in the sauna and then have a good long shower.
The Inevitable Release
Sometimes it's like adding the the feeling of dedication to an imaginary book you've just finished writing. Sometimes it's a wild impulse to stretch, and stretch, and stretch a certain part of your body. I've even compared it to evolving like a Pokemon. When it passes, there is a new bedrock layer of peace and understanding. Maybe excitement. Often some fatigue. Afterward, old memories or emotions may arise again, but never with the same level of discomfort. Eventually, you can trust that this resolution will come, enough that you might be willing to jump into the earlier stages of the cycle of your own accord. Triggers become check-ins, affirming your progress and inviting you to discover and master something new. Life now seems a rather enjoyable ride, and you make the choice to embody it as your lovely, if imperfect self.
Postscript
When I first wrote this, only a few days ago, I had no idea I was pregnant again. But my body knew. My energy shifted. My brain saw it, and my spirit stood up and declared it was time for some things to be said. To be finished. I am surprised at how happy and settled I feel. It will be different this time. And instead of the hurt, I will have something new to remember. I chose. I healed. I conquered. I know you will find this for yourself. You have everything you need. In the meantime, I wish you well.
Tags
PostpartumPTSDPostpartum Mood and Anxiety Disorders