Welcome to my blog!

We find ourselves in challenging times. To meet them more easily, I believe involves challenging ourselves to move beyond old, established habits and patterns.

Perhaps I am a bit late fully entering into the 21st century by starting my blog now, in 2010! In that my work and message has so much to do with slowing down and settling into a deeper knowing beyond and prior to our cultural modes, it may be appropriate to step extra slowly into the world of blogging and other cyber realities.

I suspect that, if you are drawn to my blog and the words here, you may also value this slower, deeper state we are all capable of. I invite you to read on and regularly, and hope the words below can support you in enhancing your ability to be, even in the midst of all the doing required in our modern world.

Thursday, 14 March 2013

Meeting Prenatal and Birth Trauma in Children and Babies

The little boy really didn’t want to go to school. He dilly dallied putting on his shoes and seemed to do everything except put on his jacket. His parents were as patient as possible but it was getting late and everyone was going to be late for school and work if they didn’t get out the door now! The tension built. There was such a big push to get out, and Tommy didn’t want to budge.

Does this sound familiar? How many parents go through similar scenes? You might say that is just part of being with children, but actually, it is usually part of being with children with unresolved birth trauma.

Going to school is a transition. Just like getting out of bed, going to bed, getting in or out of the bathtub, or in and out of a car. We go through a transition every time we walk through a door. Our first major transition in life is our birth. How we experience it tends to set an imprint for how we will meet transitions throughout our lives.

It is often surprising to parents, and others, to consider that the way children are born can have a profound effect on their lives. It used to be believed and medically promoted that babies did not really have consciousness and could not remember their experiences. If we only consider verbal memory, this may be true, but memory is not only verbal. Long before we develop the ability to speak, we are learning about the world we find ourselves in.

We learn and remember through our bodies. Various sensations give us information and teach us how to interact with our environment. You can see this in animals, who do not use words. If a dog burns himself, he will not go near the fire again. If an animal is hit, it will avoid the person who caused the pain. Babies are no different. In fact, all of us have this kind of implicit, nonverbal memory. This is how we know how to ride a bicycle.

One particular demonstration of implicit memory, published in 1911, has always impressed me. A Swiss psychologist, Édouard Claparède, would greet an amnesic patient each day, or sometimes just minutes apart, and she never remembered having met him before. One day, he hid a sharp pin in his hand when he shook the woman’s hand so that it pricked her. Although she later still had no conscious memory of having met the doctor, she refused to shake hands with him again! How many of us are reacting to our lives in the same unconscious way? In the field of Prenatal and Birth Psychology, we see this phenomenon everywhere!

All of us have been through birth. For most of us, this important, formative time of being in the womb and then emerging from it is just a story we have been told by others. I have heard all my life that my father had told mother not to interrupt him to go to the hospital during his favorite TV show, Dragnet. My due date was the next day, but, just as he was settling into his show, it was time to go to the hospital. I’m sure you have heard stories about the time of your birth. These stories are important to the tellers, but may not relate to the baby’s experience. Similarly, the evaluation of how easy or difficult the birth was may be quite different for the parents and birth attendants than for the baby.

Remembering Birth
Babies have experience. They are sentient beings long before they emerge from the birth canal. It is not unusual for toddlers to talk about their birth, or even the time in their mummy’s tummy. Some even talk about how they were conceived. What may be surprising is the degree of accuracy with which they report events and scenes that they had no apparent way of knowing anything about.

“Most disarming of all birth memories are those expressed by very young children. Inspired by some feeling, experience, or association, toddlers may surprise their parents with explicit memories of birth. Like the children themselves, these memories are innocent, unpredictable, and spontaneous, and they constitute an important new body of evidence for the reality for birth memory.” – David B. Chamberlain, The Mind of Your Newborn Baby, p. 97

As children begin to talk, they are guided by the adults around them as to what to talk about and how. There are certain things that are not accepted. Often, prenatal or birth experience is one of them. Talking about more “real” things generates praise, reflection and feedback that encourages them to continue focusing on these types of things. Talking about their birth, like describing past lives or imaginary companions, becomes something they are expected to grow out of, just the effect of an active imagination.

It turns out that toddlers can be very accurate in describing their experience. Similarly, adults regressing back to the time of their birth often describe the scene with incredible accuracy. Their body movements in regression also accurately depict how their birth happened. How can this be?

Through implicit memory, we remember experiences in the womb and during birth through our bodies. If these memories are not reinforced or reflected back to us when we are learning to speak, our body memories don’t have a chance to be integrated into explicit, verbal memory. They continue to influence our behavior unconsciously until such time as we are able to bring them to consciousness and integrate them more fully.

Supporting Little Ones
We can support our children in not having to stay locked in prenatal and birth patterns as we may have throughout their lives by first of all acknowledging that they had an experience. Talking about their time in the womb and at birth, not only from our perspective but inviting theirs can be profoundly healing. Babies often feel unheard and poorly met in this early time. At birth they cry to communicate their pain, terror, rage or aloneness. It helps when they are picked up and held, but what helps even more is to acknowledge their feelings. We all appreciate being heard. We all want to be understood. Babies want that, too. They also need reflection to feel safe. Their survival depends on their caregivers perceiving their needs. If they feel missed too often, babies begin to shut down. There is not much else they can do.

Understanding how babies (or anyone) responds to stress can be helpful in supporting them. Our autonomic nervous system, which controls our stress responses and basic metabolic functioning, consists of three parts. According the polyvagal theory of Stephen Porges, we respond to stress in relation to how these parts developed in evolution. Our social engagement system, which enables us to talk and listen to each other, make eye contact, and generally engage socially, is the latest to develop and the first we humans employ when encountering potential threat. We immediately look to see if there are other humans or friends around and how they are responding. Toddlers check to see how mother responds, to help them know if they are safe or not. Our social engagement system also enables us to cooperate with others to protect ourselves. Where a baby is unable to run away from a predator, a mother can carry the baby to safety.

Running away or fighting relates to the next level of response, the sympathetic or fight-flight nervous system. When activated, this system directs blood to the big muscles of our arms and legs to enable us to fight or fly. Our muscles tense up. Our jaws prepare to bite. We feel anger rise to protect our boundaries. Babies are not big or strong enough to fight or fly, but we can sense the anger or rage in their cry. If you listen to a baby cry, it will first sound like the little one calling out, “Mom, are you there? I need you.” If there is no response, the cry becomes louder and more forceful. “Mom! Where are you!” Newborns cry like this when they are handled roughly or in pain, separated from mom, or not responded to when they cry more softly. After some time, if they still are not responded to, they stop crying. They may then become a “good baby.”

These are the babies to be most concerned about. The third level of the autonomic nervous system is the parasympathetic. When we feel safe and settled, this is the part of our nervous system that supports rest and rejuvenation. Blood that has been directed toward the limbs for fight-flight and speed, now returns to the organs. Digestion that was put on hold during the threat can now resume. The rebuilding of the body becomes a central activity. In extreme or prolonged stress, however, the parasympathetic nervous system slows us down more extremely. This is where animals “play dead” to avoid being eaten by a tiger. If the tiger persists in its attack, the animal is spared the sensation of pain. This is a state of dissociation or freeze, where our awareness of our bodies and their sensations is lessened, along with our sense of aliveness. Good babies who are in this state, do not resist anything their caregivers want to do with them. They are not present enough to resist. They are not in touch with their sympathetic anger and resistance. That would give them strength to resist, but they are not really home or able to object.

Just to clarify, some babies are good babies because they are genuinely happy and peaceful. These babies have a sense of aliveness and tone in their bodies. Dissociated babies feel like they aren’t quite there. They may not make eye contact or have a vacant look in their eyes when they do. Their bodies may feel relatively limp or stiff. They may have a particularly pale complexion. They often have health problems and an underactive or overactive immune system.

I find it useful to have this knowledge of our stress responses so as to recognize what state a child is in and to support them being able to engage in the next level of response. A child lost in dissociation may need to find a way to push and resist. A child who is always having tantrums may need help to socially engage, to find words, to hear sounds, to make eye contact.

For toddlers and older children, games can help support this nervous system expression. Babies and toddlers can be supported by moving through transitions and making changes slowly, explaining to them what is about to happen and why, listening when they cry, putting into words for them what they are expressing, and, most of all, being clear that you really want to know what their experience is. And, yes, babies do understand what you are talking about! I have worked with newborns who look at me with obvious relief and joy when they realize I understand that they are expressing their birth and am interested in it.

Little Ones Showing Us Their Birth
Babies and children act out their birth experience so often. Babies will show you their birth by turning and pushing through your hands, if you support their weight and respectfully follow their movement. Toddlers and older children seek to resolve or master their birth by climbing into boxes, tunnels, cubby holes, baskets or anything they can fit into. If they were born prematurely or their birth was induced by medication or other interventions or circumstances, they may need time to just be in their chosen box, their invented womb. They need to make up for the time they missed. They then need the opportunity to find their own way out of the womb. This applies also to children born with forceps, vacuum extraction (ventouse), caesarian section or other forms of assistance. They need to find their own timing and their own way out.

Children crawling through a play tunnel will often stop at the point representing where they were stuck in their birth. Reflecting this back to them in simple words like, “Oh this is where you got stuck,” can facilitate their integration of this experience. Children born by cesarian section may have a difficult time getting all the way through the tunnel, or completing things they begin.

I remember one little boy I worked with years ago who would always push his way up out through a hole in the tunnel half way through. He needed to re-enact his cesarian birth several times until he began to see that there might be another way through. He would then go a bit further each time he went in the tunnel, until, finally, he went all the way to the end. Up to that point, he sped up and became anxious midway through. Each time he popped out through the center, he was held and reassured by his mom. This was an important re-patterning of his actual birth experience, where he was taken away from mom and put in an incubator. When he had been reassured enough, and also encouraged to find the strength of his anger when it arose, he was able to get through the tunnel and felt very proud of himself. His issues with transitions shifted dramatically after that.

Children also play out their traumatic past with toys. They will push them through a tunnel and create resistances for them. They will perform surgery on them, pull them with forceps or give them needles to be empowered in relation to drugs and medical procedures they experienced. Providing medical types of toys, with doctors, nurses, hospital beds and equipment can facilitate this kind of play.

Children can work through the trauma of separation from mom at birth by playing with mother and baby animal toys. It is important in addressing prenatal and birth issues that children be allowed to choose their toys and activities in play, rather than being led by an adult. Birth traumas inevitably involve being disempowered and having our own needs, timing and boundaries disrespected or ignored. Children can find these again and reclaim them through their play. Witnessing their play can be helpful, including reflecting back to them what they are doing. Oh, the bear is moving through the tunnel now. He is finding his own way through. Oops, he got stuck there. How is he going to get out now? It’s not always necessary during this play to interpret each action in relation to the child’s birth. It may be easier for a child to process these events through symbolic play, where the actual story may be overwhelming.

On the other hand, children often want to hear the story of their birth. Acknowledging what was difficult or scary can be extremely helpful. Keep an eye on the child’s reactions as you speak. An overwhelmed child may become anxious or over-active, or may dissociate and feel less present. If the child shows any signs of distress, pause the story and check in. Give the child time to express and process. Speak slowly. Take time to play, to cuddle, to reassure, to be with what arises.

There is so much to talk about regarding how to support babies and children in working through their early trauma. While there is not space here to go into every detail, I would like to cover one more important piece. That is how you are present with the child. Most of us have our own unresolved prenatal and birth traumas. If your own trauma is touched while being with the child, it is essential that you have support to work through your own history.

Children, like any of us, need to be heard and seen. When we are meeting them from within our own history, we are much less able to hear and see what is actually being presented. Daniel Siegel has an excellent book, Parenting From the Inside Out, to guide parents in working through their own issues that arise.

If you are a parent or spend time with children, you have probably noticed that your issues will arise in relationship with them. I see that as one of the gifts babies and children bring to us. Our own childhood is reflected back to us, offering us an irresistible opportunity to heal. Our own healing can be one of the greatest gifts we offer to the little ones coming in.

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