Therapy: Part 2

With the challenges I faced, I knew I couldn’t be alone in my therapy frustrations. I conducted an informal survey through Facebook, polling 40 women who had experienced pregnancy loss after 20 weeks gestation. (In actuality, 45 women completed the survey but in order to view the last 5 surveys, I would have to “upgrade” my plan for $77, um, no thanks). There were ten questions in total.  I’m not a social scientist and haven’t conducted many surveys or polls so this wasn’t by any means professional or scientific. And of course a 40-person sample size is much too small to make conclusions, so remember, this was, you know, a blog experiment.

The majority of those polled live in the United States, followed by the United Kingdom and Canada; Australia and New Zealand each had one response. The “Other” response was from the Netherlands.

pie-chart (7)

Most of those who responded have counseling as a covered service under their health insurance plan.

pie-chart (2)

Besides grief and trauma, some polled sought counseling from therapists specializing in perinatal loss and marriage (documented under “other”).

pie-chart (5)

Of those polled, 71.8% have seen a counselor; the “other” category comprised four responses: 5 counselors, 6 counselors, “I saw a few one time but didn’t like any of them.” “first meeting this week”.

pie-chart (8)

Sixty-four percent (25 people) of those polled are not currently in counseling.  (The “other” responses were those who are anticipating starting counseling in the very near future).

pie-chart (6)

Of those twenty-five, thirteen people (52%) gave responses related to the difficulty of therapy. Some comments include:

I felt they [the therapist] wouldn’t be able to understand what I was going though and I’m not very good at sharing my thoughts. I also thought they may think I was unsuitable to have another baby.

I found that I was unable to be truthful with my counselor. The one time I saw her, I pretended to be okay and gave all the right answers. I wish I didn’t. I wish that she had pushed me harder rather than just seeming to accept everything I said… I mean, I showed up to talk about my baby’s stillbirth, she should have guessed there was ‘more’ to what I was saying.

I am not yet ready to do some things that I know they [the counselor] will want me to work through. As soon as I feel [that] I am in a spot where I am ready to work through the grief than, I will go.

There were five responses (20%) that pertained to a lack of connection with the therapist. One comment, which unfortunately didn’t surprise me was I couldn’t find one that wasn’t rude or judgmental.” Another mom reports “the counselors that my insurance covered were not specialized for my issues, and mostly were just inept for my emotional/psych needs.” (Again, not surprising).

Three moms were still looking for a counselor, one mom saying, “I don’t know where to start. I don’t know how to find someone. Everyone seems to think I should be moving on already.”

Six moms responded that they are no longer in counseling because they felt their goals were completed. Two of those six were pursuing support elsewhere. Six of the forty polled mentioned other support (either instead of or in addition to) such as in-person support groups, online social media support, family and friends.

I felt like my counselor gave me good advice and tools to work from. As far as actually processing my grief, it was more beneficial for me to speak with trusted mentors and family.

I felt I got what I needed from my counseling experience and I am at a point in my grief that I am able to cope without counseling.

I saw a private counselor within a week of losing my daughter at 38 weeks, but had to relocate 3 months later to an area where that wasn’t available. Private counseling is cost prohibitive long-term so I will be starting with the public women’s mental health team now that I’m back in an area that has that service available.

Two responses related to cost, the one above and this one:

[I] was told by [the] mental health team to wait 4-6 months or pay for private counseling.

Other comments

I have been going to pregnancy and infant loss support groups for the time being and that has been helpful. But not one-on-one counseling yet.

I wish there were more low cost, easily accessible options for quality counseling specific to the grief process as it applies to my stillbirth loss.

I do wish I had sought counseling sooner (I went about 9 months after my loss). I may still seek counseling as I’m still not feeling okay 1 year out.

I struggled with knowing she didn’t truly know how I felt.

The counselors made it so much worse, really so mean.

I’m not sure I would have been able to grieve appropriately if I didn’t have that support. It gave me perspective, direction, and helped me keep moving forward. It helped reduce the guilt and isolation I was feeling.

My counselor helped make my thoughts/feelings validated when at times I thought there was something wrong with me. She also really helped my husband and I learn to communicate better.

Finding therapists that specialize in pregnancy loss was near impossible. I’ve tried several times and have never really had any luck.

How I would have changed my poll

I don’t think it was important to know the week gestation of infant loss (I didn’t even include the graphic); more important, would be to know how far out the mother is from her loss. One question I asked was terrible: “It was easy to find a counselor post-loss” with a 1-5 scale rating (1= strongly disagree, 5=strongly agree). I couldn’t draw any conclusions from these responses. What’s the definition of “easy?” Finding a counselor in general or the right counselor? It was too broad. I think what I was looking for was how people found their counselor or how many counselors did they go through before finding the right counselor. Or maybe if their hospital or ob-gyn/midwife gave them a list of bereavement or perinatal loss counselors.

So much of what these women shared I could really relate to. Basically, as a society, not only are we failing families by not implementing time and money into stillbirth research, but we are failing mothers. We are failing to provide the mental health resources they need in order to move forward (NOT “move on”) and gain the tools needed to function in life. I echo what some of these moms said: finding the right counselor for pregnancy loss is extremely difficult. A grief counselor may not cut it–this is a very different type of grief, often involving trauma. A counselor who specializes in trauma and PTSD may actually be better-suited to help a mom who has experienced a pregnancy loss (but may not have the education and experience to help with the grieving process). There are therapists who specialize in perinatal loss, but they seem to be in larger metropolitan areas–there aren’t any in my rural New England state (that I could find). The fact that there aren’t more therapists specializing in perinatal loss is baffling to me, when we look at the numbers.

In the United States annually:

  • 500,000 pregnancies end before 19 weeks
  • 26,000 pregnancies end after 20 weeks
  • 19,000 babies are born alive but die within the first month

In the United Kingdom, annually

Clearly, there is a need for qualified perinatal loss therapists. So, a family has experienced a devastating pregnancy loss and wants to pursue counseling. How would one go about finding an experienced and knowledgeable therapist? Start here.


Are you a therapist? Do you specialize in perinatal loss counseling? Would you consider specialized training in perinatal loss counseling?

If you have questions about the poll, please feel free to ask!

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Therapy: Part 1

In most Western countries, our healthcare focuses on the physical–we comply with the recommendations for annual physical exams, biannual dental cleanings, and yearly eye exams.

But we neglect our mental health. The times I’ve sought counseling were for a specific purpose and usually the event was abrupt, leaving me little time to thoroughly investigate who might be a good “mental health match” for me.

My husband is the one who found our first counselor post-loss. Because he was aware of my history of depression, and concerned about the effect of our baby’s death on our marriage,  he sought recommendations from coworker and found Meryl (not her real name). Meryl has a PhD in clinical psychology from Ohio University. She completed a predoctoral internship at Harvard. (Impressive). Her website maintains that she has been in practice for twenty years and specializes in stress/trauma and PTSD, anxiety and depression, and women’s issues.

Our first session with Meryl was June 8, a bit over 4 weeks post-loss but exactly one month from the death, delivery, and birth of my youngest daughter. (The delay in securing an appointment sooner, having to do with the fact that Meryl practices part-time and also had been on vacation). Meryl had been briefed on the trauma, yet she was clearly uncomfortable with the topic. She wasn’t familiar with the language around pregnancy loss, she never used our baby’s name, and at times, she seemed to be looking my way for direction on how to counsel me.  She couldn’t seem to identify what I needed (and I certainly didn’t know).  Her ideas about helping me ease back to work were ridiculous.  My husband and I met with Meryl twice as a couple and I met with her three times individually, then never called her back. Meryl didn’t bill insurance so we paid upwards of $200 (USD) per counseling session.

Now what?

Several people had recommended that I seek a therapist certified in a type of  treatment called EMDR . I searched on the Psychology Today website and another therapist-search site specific to the state I live in. I found this process to be frustrating. On the Psychology Today website I could filter by town/zip code, insurance, treatment modality (cognitive behavior therapy, EMDR, trauma-focused, hypnotherapy–among others) and issue (grief, depression, trauma and PTSD, women’s issues–among others). I WISH there was one titled “perinatal loss”. Even a quick google search “perinatal loss stillbirth name of state” got me nothing. So I went with trauma/PTSD and grief.

That’s how I found Mindi, my second therapist. Her credentials weren’t as impressive as Meryl’s, but at this point I had little faith in credentials. Mindi is an LCSW with an additional credential in EMDR therapy from Boston University. She has been practicing as a therapist for over ten years. And great news–she did bill my insurance and my copay per session was $6 and some odd-cents (USD).

I had high hopes for Mindi. Our first session was 9 weeks post-loss and it seemed like she was going to be the counselor to help me move through this.  We met for a total of eight sessions, our final session ending a little over 18 weeks post-loss. Five of the eight sessions involved EMDR therapy. And then I felt like I had run out of things to talk about. We’d covered the initial trauma of the loss, my transition to my new job, parenting a living child post-loss, triggers, some coping mechanisms and tools….what else was there? Plus, there were the sad pitying puppy-dog eyes and pouty lip that frequently dawned Mindi’s face when I shared a particularly heart-breaking thought. While the EMDR seemed to help (I think?) initially, I couldn’t foresee myself doing much more of it. (EMDR involves reliving the trauma). So we concluded our counseling with the understanding that I could call for a future appointment if needed. (I won’t call her). (One of the interesting things about Mindi’s location was that her office was upstairs from a bridal boutique. Everytime I went, I wondered if someone seeking counseling post-divorce would find this to be a trigger).

Am I better? Well, I suppose I am better than I was on May 9th. Am I well? Cured? No longer in need of therapy? I don’t know. I still cry daily. But maybe this is how it will be for the rest of my life. The most difficult thing about counseling for me, as an introvert, is expressing myself verbally. This was one clear advantage of the EMDR therapy.  I didn’t need to explain anything to my therapist. She didn’t need to have my life story or know every detail of the trauma. By default, the modality of EMDR took care of it. What would therapy for introverts look like? I think a written journal, email sessions, better yet–here’s the link to my blog–read it and know everything I’m thinking, then help me.

I knew I couldn’t be the only person with this frustration, so I decided to complete an informal poll.


Did you try therapy? What was great? What was awful?

Bella Luna

About a year ago,  my then-3-year-old and I started listening to The Laurie Berkner Band.  One song that I particularly grew to love is entitled Moon Moon Moon. And even though it’s a bit silly (“I have found that it looks just like a pizza pie!”), the harmony is beautiful. We’d be driving home, the moon ‘following’ us, and I would sing to my daughter “Moon, moon, moon, shining bright; Moon, moon, moon, my nightlight; Moon, moon, moon, I can see; Moon, moon, moon, you’re taking care of me.”

Tonight I went outside to take a photo for #CaptureYourGrief2017. I snapped a few photos of the moon. In each one, there is a small white circle. An orb? Or maybe just a dust particle, a reflection, maybe nothing. But maybe, just maybe, it’s something. I want to believe.

#WhatHealsYou


I don’t even have a great prompt. What are your thoughts?

Remember Your Strength 

Capture Your Grief Day 3: Meaningful Mantra

#CaptureYourGrief2017 #WhatHealsYou

My friend, Amanda, gifted me with this gorgeous bracelet, made at Saucy Jewelry. Engraved inside: “Remember Your Strength”. That’s been my mantra since I got it. I wear it everyday. And when things feel too difficult, I touch my bracelet, close my eyes, and tell myself “Remember Your Strength. Corva Florence.”

What’s your mantra? Do you have an ‘anchor’ to ground you? 

Remembering Babies, Gone Too Soon

Capture Your Grief Day 1: Sunrise Blessing

In 1988, then-President Ronald Reagan declared October Pregnancy and Infant Loss Awareness Month, saying “When a child loses his parent, they are called an orphan. When a spouse loses her or his partner, they are called a widow or widower. When parents lose their child, there isn’t a word to describe them. This month recognizes the loss so many parents experience across the United States and around the world. It is also meant to inform and provide resources for parents who have lost children due to miscarriage, ectopic pregnancy, molar pregnancy, stillbirths, birth defects, SIDS, and other causes.”

Like other awareness campaigns (think “pink” for breast cancer, “purple” for Alzheimer’s and “red” for HIV/AIDS), the PAIL community uses a blue and pink ribbon as a symbol to heighten awareness. Pregnancy and Infant Loss Day (October 15th) is recognized in the U.S., as well as five additional countries.

In his speech, Reagan highlighted 3 goals: recognition of baby loss, information for parents, and resources for parents. However, something vital is missing: raising awareness to the public. Before I was a statistic I was only peripherally aware of PAIL Month. Sure, I’d seen blue and pink ribbons on Facebook profiles, but I didn’t truly understand. Now I am that parent. I frequently remind others in the loss community that “people are uncomfortable with death, but they are exponentially uncomfortable with dead babies.”  The death of a baby is shocking and unanticipated–babies are not supposed to die.

If you are someone who has experienced the loss of a baby, I challenge you to speak up in a way that feels right to you. This could be using a Facebook profile frame for PAIL month, writing a note to a friend, speaking up during a conversation about loss, or commenting on a Facebook post. And if you haven’t personally experienced the loss of a baby, you know someone who has, even if you don’t (yet) know who in your life that person is. So if they bring it up, be ready.

On October 14th, I will be walking in the 2017 Empty Arms Remembrance Walk for my Baby C and all babies gone too soon. I would encourage everyone to check this site to find a local event to offer your support.

If nobody speaks up, then nobody knows.


Before your loss, how aware were you of Pregnancy and Infant Loss Awareness Month/Day. How, if at all, will you commemorate your baby this month?

On Friendship 

ACT 1

Today a coworker, let’s call her Fran, came into work with her newborn. I saw her down the hall showing him off to two other coworkers. I quickly slipped into my office and closed the door. No way was I going to handle that well. Later, a friend told me that Fran had been looking for me specifically. Eek.

The thing is, I feel like Fran should know better. She’s the one who wanted my address so she could send me an invitation to her baby shower. (Clue #1: no response to the text). She’s also someone who rescued me from taking baby appointments during the 22 days I worked at WIC post-loss. (Clue #2: me bawling in my office after seeing a baby). Later, this afternoon I noticed an envelope in the box on my office door. Thinking it was from someone else, I opened it. A thank you card. With a  photo collage postcard of her living baby. Pre-loss, I magneted photo cards like this onto our fridge.   Uh-uh. No way. I tried to pawn off the card on my living daughter but she had her own choice words to say about that baby. What the hell am I supposed to do with this card?

ACT 2

Six weeks after my loss, a friend, let’s call her Holly, phoned to tell me she is pregnant. (A rough way to receive such news, as I desperately held back tears while congratulating her). And even though I have known this woman for nine years, and even though she was one of the first people to reach out to me in my grief and offer her support, I have drawn back from her. I have stopped responding to her texts. I have neglected to return her phone calls. Last week I had a meeting in the building where she works and I couldn’t bring myself to stop by her office. 

Fran and Holly didn’t dump in or say hurtful platitudes. All they did was get pregnant and deliver (or expect to deliver) a living baby. However, I selfishly don’t want anything to do with either of these people. I don’t want to see them or talk to them and I CERTAINLY don’t want to see their babies.  This is incredibly unfair to both of them. 

Then again, it is incredibly astronomically unfair that my baby died.


In the midst of your grief, did you lose friends as a result of circumstance? Were the friendships eventually mended?


 

The Ring Theory 

When tragedy hits, people often don’t know what to say or do. Some grief-stricken individuals will reassure others that saying something is better than saying nothing. I don’t agree with this, although I can understand the good intentions behind it. I think what people mean when they say “It’s better to say something, even the wrong thing, than nothing at all” is that they wish for others to acknowledge their loss, they wish for their loved one to be remembered and they don’t want that awkward “elephant in the room” feeling. However, saying the wrong thing can be devastating, even going so far as to destroy relationships. One of the best resources on this topic that I have found is this one. To summarize the ring theory “in a nutshell”: comfort in, dump out. When I apply this theory to my own situation, I place myself in the middle. Directly around me is my husband and living daughter. Surrounding them, our parents, then close friends and family, and so-on. The most important part of the theory is this:

“The person in the center ring can say anything she wants to anyone, anywhere. She can kvetch and complain and whine and moan and curse the heavens and say, “Life is unfair” and “Why me?” That’s the one payoff for being in the center ring. Everyone else can say those things too, but only to people in larger rings.”

I had a few people “dump in” on me, but only once did it affect me enough to destroy a relationship.

A pregnant friend (and my hired home birth midwife) disclosed to me that she had been having panic attacks since my delivery. She told me that her partner, the father of her baby, was asking her to cease communicating with me as he was concerned that the stress of my situation was affecting their baby. She was having panic attacks? My daughter died. She died. In my body. My “friend” also told me that she was grieving for my baby. She was grieving for my baby? Yes, it was valid for her to feel this way (I realize this now). BUT it was absolutely NOT ok for her to “dump in” on me.

I felt guilty. If something happened to her baby, it would be my fault. I had ruined her life by delivering a stillborn baby. I had caused her undue stress. Her stress was going to harm her baby and it would be my fault.  These are the irrational thoughts that consume someone who is grieving.

And I felt (still feel) angry. Extremely angry. Like, irrationally angry.

Crazy angry.

Our communication ended, along with our friendship.

Before our friendship ended, this is what she told me: “So much love to you, my friend. I’m holding you all in my heart every moment and I will walk with you as you put one foot in front of the other. {{{hug}}}”

That was a lie. A promise she could not keep.

Comfort IN, dump OUT.


Did you ever experience someone “dumping in” on you during your grief? How did you handle it? Did it affect your relationship?