Monday, 13 February 2017

Friday, 12 February 2016

I recently posted the following explanation of  the services Afterthoughts Counselling and Training provide, on Lindsay Robinson's blog. Lindsay has recently been diagnosed with postnatal depression. Her blog is encouraging conversation and story amongst Mums who have experience of PND. I thought it might be worth while re-blogging here. Please visit LindsayRobinson'sPage   https://lindsayelizabethrobinson.wordpress.com/2016/02/03/support-post-afterthoughts-ni/

Monday, 4 January 2016

When attachment and bonding isn’t spontaneous.

In an ideal world, as a baby is born, it is held by its mother, and that mother-baby connection is swathed in happy hormones and instinctive behaviours. Bonding and attachment are evident and the room will be filled with ahhs and awws. I’ve just described a perfect scenario, just like this in my previous Blog. As a midwife with a very deep interest in normalising birth I can recount many other wonderful experiences that meet these expectations for greeting a new baby. It’s the image every film, where childbirth has been part of the story, has presented us with since we were tots ourselves.

It seems natural then to assume in pregnancy that there will be a rush of recognition and love by its mother immediately as baby is born. If this is a wanted baby then lots of recognition of behaviours of the developing baby are already a part of the Mother baby bond. She will be noting sleep and activity patterns, rubbing the tummy and talking to the bump, recognising hiccups, taking an interest in growth charts and scans. The mother who has been waiting for him or her for 9 months anticipates instant recognition and love. Even if there is an understanding prior to birth that not all women experience an immediate attachment at birth, the expectation is then (of course) that this distancing will normalise soon. For most women in this situation this will be true. 

For many others however this is not the case.

Later, for some, instead of remembering a rush of delight and love, a woman looks back at her baby’s birth, she feels little recognition, or memory, and no happiness. When this is a person’s real experience it can be bewildering, scary, and leave a new mummy feeling guilty, bad or sad.

We are story tellers, and in pregnancy and after childbirth, particularly so. When poor attachment has occurred, how does a new Mum explain that lack of immediate connection with her baby to herself? How can she say this out loud and who does she talk to?

I remember my first awareness of the impact natural hormones have on a woman’s body during labour. A woman’s ability to access this wonderful cocktail depends on so many personal and environmental factors. When it all comes together though this exceptional experience creates the exceptional stories. Labour is easier. Birth is easier. Attachment is easier.

What I have recognised in the counselling room is that the protective capacity of these hormones on a woman’s emotions and memory during her labour and birth also carry into the postnatal period. The opposite is also true.

Birth trauma; the psychological disruption to a person’s sense of safety, disrupts the ability of the body to maintain the protective cocktail in labour, at birth, or in the immediate period after birth. Fear enters the equation. A woman feels frightened, responds to a perceived threat to herself or her baby with fear. Then stress hormones visit instead. Again in the counselling room the effect of these events are very real and painful. What is wonderful is that they are most often easy to normalise very quickly. What is sad it that it may have been years since this fear response began.

There are so many reasons why it can take a while longer for those feelings of attachment and connection to happen either during pregnancy or at birth. Some require a little processing because they are so hard to think about. Talking about a lack of emotion for a new baby can seem impossible. It would be very natural to feel afraid that people wouldn’t understand. Starting that conversation with the baby’s dad, a midwife or health visitor, GP, Mum or a friend can reduce the feelings of guilt or confusion.

Talking means a woman’s own mind starts to explore those feelings. She may remember that the labour was very long and think about how impossibly tired she was. Or she may realise how many other things she was worried about. Complications may have meant she was depleted in emotional and physical energy.

Midwives and Health Visitors are placing a much greater emphasis on attachment behaviours. During antenatal care and through to the rest of a child's life, the importance of talking, touch, eye-contact and connection with little ones is spoken of again and again. Babies have learnt to hear their parents’ voices while growing inside the uterus. The baby knows its parents at birth. They are immediately curious and hard wired to connect.

When it is hard to bond
Best advice. First Aid. Actively pretending is the best thing a woman can do. Going through the motions as though she really feels them will help to safeguard the baby’s bonding, and start their journey towards emotional security early. Remembering to look into baby’s eyes and smile, provide touch and cuddles. If a baby cries and Mum responds with provision and care it orientates the baby into security. They learn in the centre that they are ok. The mother is growing the connective pathways, so that when her mind settles and she is emotionally able to bridge that gap, her little one already knows how loved and important s/he is. Their security-centre has been filling up with every connection since they were born. Consider talking. If anxiety symptoms are present it is wise to talk about these things too.

Tuesday, 22 December 2015

Attachment and Bonding: 1 of 3 Anne Marie McKinley

So I have a wee story that I always tell when I am taking Parentcraft. 

I love telling it. 
When I do, complete with Spanish and Northern Ireland accents, just looking around the room I get to see aww! in the expectant faces of about to be Mums and Dads.
And it's a true story. 
I introduce it with 'I wish I'd had a camera'... It was such a moment!! All about how clever and tuned in brand new; moment-of-birth-new-babies are. 
The Story goes like this.
It was a first time mummy in the pool.  Almost there. The room was warm, she was sitting upright. It had been a good labour and transition to birth in the water went well.

As baby, a bright alert and small little boy, came into his mothers’ arms, she held him close as she now transitioned gently into realising he was there. She moved him a little away from her body, cupping him in her hands, his body warm beneath the water, and almost sang what sounded like a song of welcome. 
The fact that she spoke Spanish and I couldn’t hear any, for me just added to the atmosphere. We were all focused on this little boy and watching his colour change to a gorgeous pink, we were all enjoying the moment.

This baby was a little bit early. This was evidenced by the amount of vernix (a thick oily substance that protects the baby’s skin when he is growing in the uterus). The eyes of the baby were stuck fast with vernix.

As Mummy was supporting him and singing this song of welcome, the baby stilled, and slowly moved his head from a resting position to face his Mummy. His head bobbed a little until his eyes and her eyes were parallel. Then his eyes popped open as his eyes found hers.

Then as if to say ‘ok that’s what you look like’, he reverted back to his original resting, held securely by his mum.

We were all in the room spell bound. I said to the Dad, ‘now, it’s your turn’.
Not a bit shy and in a lovely broad Northern Ireland accent he said
 ‘ach, my wee son!- You’re very welcome!’ 
He kept chatting like that and the baby started his search again. This time his face looked over his mother’s right shoulder to where the daddy was crouched. His eyes again were closed. The faces again became parallel. And once more he popped open his eyes, found his Dad’s eyes, they checked each other out for a moment and then once again he returned to a resting in his mother’s hands.
But I didn’t have a camera. 
But still…Magic.

So this is my story on the eve of my (early) retirement. I am going still to be working some hours to maintain the Birthafterthoughts Clinic I currently work in. But lots of changes are coming, and I won’t have the opportunity too often now, I imagine, to tell this story in Parentcraft classes.

With my wonderful new counselling team I am hoping to counsel and teach and enjoy working in different ways both with men and women in relation to stories that are often the opposite of this amazing dreamlike event.

So more serious and difficult birth stories will instead, no doubt be the backbone of an ongoing conversation here.

Part of presenting the harder and more difficult places that women and men find themselves in post birth is that these are not always pretty stories. Yet the folk I have worked with whose stories are of this second kind have taught me all the same, about courage and strength, and resilience and healing.
Start well believing it can be better.  Leave 2015 with the best of the ideal.

Part two of attachment and bonding which I am planning to post early January will be about when it isn’t like this at all. When singing isn’t really the response a new mum feels at the moment her baby is born. 
Another day.
Meanwhile. Happy Christmas. See you in 2016                                        Anne Marie McKinley

Thursday, 19 November 2015

The birth of a Birth Trauma Counselling service

I have paused before penning a blog entry.
It’s a very self-conscious beginning.
There is something about my training that would have me prefer to blend with my colleagues and the system. There we’re a unit and connected, and collectively true to the values of our professions. Putting my head out, goes a little against the grain!

I am very grateful though for all the lovely people who are beginning to see the website and like the Facebook page. Thank you all.

I wondered too about the tone. Should this blogging-adventure begin in a very technical and knowledge based attitude? While I have learned a tremendous amount and do hanker to share some of these insights, it has mostly been a very personal journey.

When I applied to do a counselling Diploma with Vital Connexions I had no idea where that decision would lead me. I suspected I might work with locally based trauma themes. Northern Ireland has had a very deeply wounded history and I suppose I believed I might find my way into working with folk affected in that story.

I certainly had no immediate desire to launch into the world of birth trauma. I admit that my own knowledge of that process was very limited. I certainly didn’t believe the birth trauma world is the very misunderstood and complex one that it is.

Having said that Midwives are well informed and are very aware that post-traumatic stress and postnatal depression can result from a difficult birth experience. I suspect all the same that most of us infrequently converse about the full human cost; or witness the psychological responses that affect the whole person, the parent child relationship, the couple and family.

My journey began when three mothers told me the same story. After a normal birth, one week apart, each baby 4, 7, and 15years after the birth of their mother’s first child, the decision never to give birth again, the ‘terror’ the women experienced in childbirth, the wonderful subsequent normal birth and the relief of speaking this story out loud. Stories untold to a professional before that day. These three stories began the NHS Birthafterthoughts service in which I have had the privilege to provide therapy to hundreds of men and women.

5 years later a client will now and then ask me what I’m thinking about. (I know! Topsy-Turvy counselling). I will be wondering how I could teach this. How that particular therapeutic moment could become a lesson, a deepening of the possibility that more women, more men, might find a place to be heard. That those affected by the trauma response to a difficult or scary time will have access to the type of therapy that can bring immediate and full relief to the awful feelings that they are now experiencing.

A few years ago I started to hope that the counsellors who have joined me in this adventure would believe in this dream of mine. Partnering with Chris and Linda was intentional. They have that lovely instinctive and creative quality that I regularly witness in the wonderful midwives that surround my working experience. 

The professionals I work with; Midwives and Doctors, believe in a collaborative approach, informed choice and high standards of care. While each one of us may occasionally get things wrong, as professionals we nonetheless seek to make good decisions for good reasons. Yet birth trauma is a very prevalent result of birth. We all have much to learn about these processes.

I began this journey as a counsellor in the making. Alice Graham and later Patricia Jamshedi are the Counsellor Supervisors that stretched and taught me, helped me be instinctive and informed. They gave me the confidence to adventure in this way with the women and men that I have had the privilege to care for. This journey would not have been possible without their wisdom.

This new  service hopes to do a little more. To begin to stretch the capacity for those who are affected in this way to find the help they need. To teach. To expand the team and provide a uniform and particular service for those that need it. To enable more parents to enjoy the first weeks and months with a brand new little person unencumbered by deeply disturbing emotional responses. To meet too with others along the pregnancy continuum whose stories also are difficult and painful.

Comments Welcome

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Website Design By MICAH T JONES