I used to be in the habit of deep self-pity, which was perfectly appropriate for my postpartum life. After my daughter’s traumatic birth in March 2011, I spent a lot of time thinking heavy, circular thoughts like, “why did this happen to me?” and “how did this happen?” It was these questions that started me on the path that became Transforming Birth Trauma and wanting to help other women through the process of healing. Because once I started reading, I just could not stop until I had unravelled everything to my satisfaction. Why is a question I’ve addressed — it comes down to birth being part of a complicated, sexist system that judges women and refuses them support. But how is a different question. Not “How were you traumatized?” as an accusatory question from a nosy person who doesn’t believe you’re suffering, but “How does trauma enter you? How does this feeling come to exist?”
Scientists don’t agree on the biological and psychological origins of trauma, but there is one clinician who has a working theory of trauma that seems pretty plausible. Peter Levine, who founded the Somatic Experiencing school of therapy, observed that animals often survive trauma and become wiser (avoiding areas where they were attacked, becoming cleverer), but don’t develop PTSD or post-traumatic stress like humans do. So he began carefully to review literature on animal behavior as well as working carefully with clients in his clinic, to begin to unravel the trauma from his point of view.
The Struggle for Surviving Birth Trauma in 5 steps
Most people have heard that animals have a “fight or flight” instinct when in danger, and I know I applied it to my own anxiety experience before I became a mother. But it’s actually more complicated than that. Mammals handle life-or-death situations as they’re happening in five-ish steps: alert, flight, fight, freeze, and fold. The argument is that this is normal for humans too, because our nervous system and self-defenses evolved similarly to other mammals.
Imagine a group of gazelles on a grassland, sticking together for protection, all of them scanning the environment for potential danger. If one of them hears or sees something—or “alerts”—they all together tense up and look for the source of the danger. I believe that birth trauma starts with the policing of women’s bodies and decisions, so every time we’re given orders about pregnancy and birth we start to tense up and look for danger — no mother wants to harm their child, but sometimes we’re unsure it the aggressive advice we’re given are valid things to worry about. This includes in the delivery room, especially when things are happening that aren’t explained.
2 & 3. Flight. And then Fight.
If danger is present, the first course of action is an active defense. The gazelles will all begin to run together. This is that fight-or-flight stage of survival that is well known. Actually, the first instinct is to run away to try to escape, and if that fails, to fight.
But in birthing, there’s not a whole lot of room for escaping. Sometimes in childbirth we are actually restrained, such as during forced bedrest, or very nearly so—my birthing involved every limb being attached to some monitor or therapeutic device. Sometimes the restraints are those of cultural expectations—what we should be doing and how we should be acting in order to be a “good patient,” or fear of the consequences of rejecting procedures. Without prior preparation (that isn’t usually taught in childbirthing classes, especially hospital affiliated ones), and without an advocate to speak up in the birthing room, there seems to be no way to fight back.
For me, and I think for many others who’ve experienced birth trauma, the flight or fight state was largely an internal one — I had the URGE to run, which I suppressed. I had the instinct to fight, which I ignored. This led quickly into the next part of survival from life-or-death circumstances, little known: Freeze and Fold.
4 & 5. Freeze and Fold
What’s particularly interesting about danger in birthing is that we are unable to flee from labor, we are unable to flee the hospital, we are unable to fight the doctors or other caregivers, and so it’s easy to understand that we feel trapped. In these situations—as when humans are traumatized in birthing, or when a gazelle is trapped by a predator— mammal’s next strategy is to freeze.
Fear paralysis, also known as immobility or disassociation, “triggers a profoundly altered state of numbing” (Levine, 2010, p. 50). When animals—including humans—come into this altered state of numbing, it happens because of a flood of endorphins, which means that the victim “will not have to suffer the full agony of being torn apart. […] In this state of analgesia, the victim may witness the event as through from outside her body, as if it were happening to someone else.” Women who numb when giving birth do not have to suffer the full agony of what’s happening to them, and that agony is different for each woman. Folding is the surrender that happens after the freeze — in which mammals go inside themselves to avoid knowing what is happening.
This is actually a good thing. Dissociation during the traumatic event is an evolutionary adaptation that protects us. Physically, our bodies produce pain relief. Emotionally, our minds produce a fog that clouds details so that recall is harder. However, the problem — the long-term feeling of being traumatized — comes when we continually return to disassociation long after the life-or-death situation. In my case, and likely (if you’re reading this) yours, it was the birth of our child.
We Survived the Birth Trauma, why are we still miserable?
Immobility or disassociation is usually a time limited response, one that can be shed fairly quickly in order for more survival actions to be taken if the opportunity to arise. (In other words, usually immobility can be shed so you can run away when the predator’s back is turned.) This means that even if we experience trauma, it doesn’t mean that we will necessarily be traumatized. Not everyone whose birth is scary is traumatized, not everyone who feels immobilized in fear is traumatized, either. What separates a scary birth experience from a traumatic birth experience? And if this numbing was truly time limited for us traumatized mamas, why are we still feeling the effects?
We retraumatize ourselves with the of the intensity of emotions we begin to feel again when we come back from our disassociation. Humans tend to “reterrorize themselves out of their (misplaced) fear of their own intense sensation and emotions” (Levine, 2010, p. 61). For example, intense anger or rage may frighten a mother because mothers fear that they may actually hurt their doctor, themselves, or their child, and thus “they exert tremendous effort to deflect and suppress that rage, almost before they feel it.”
I remember my rage when a friend of mine complained about having to wait for labor to begin naturally — I was so angry that she didn’t realize what kind of gift that had been given to her to carry her child to term, that I spent the rest of the day going through the motions — I began floating didn’t come down to earth again for a while. I couldn’t express this emotion safely — either to myself, and because of social strictures, neither could I express it to anyone else. I was afraid of my own emotional reaction, and as a result, I re-froze. This kept happening, over and over again, whenever I was reminded of my daughter’s birth — and that’s when a “bad birth” becomes traumatic birth, when dissociation becomes the response to memories of the birth itself.
There are other intense emotions that could cause us to immobilize ourselves to avoid feeling include guilt and/or shame, grief, and fear itself. To avoid the fear/anger/other intense emotion, we learn to simply freeze again. Even though intense emotion is a very normal response to trauma, we try to not feel that intense emotion because of its lack of social acceptability — and also because it scares us back into our trauma.
What Traumatized Moms Need to Do Next
“The very key to resolving trauma is to be able to uncouple and separate the fear from the immobility” (Levine, 2010, p. 56).
In my healing journey from traumatized mama to a wise-woman warrior mama, I tried a lot of things. I was under the care of a psychiatrist and a therapist, and while medication and talking were highly helpful to me in terms of large re-frames in my life, it was still I who had to do the daily work. The daily work is gently beginning to feel a wider range of emotions around our trauma, to no longer be afraid of our intense emotions.
Somatic Experiencing Therapy techniques, used by trained and certified Somatic Experiencing Therapists, help people reconnect to how their feelings feel in their body in a safe way — feelings that get “stuck” there because of our immobilization and dissociation. They use a technique called “titration” which helps them touch a tiny piece of the feeling and feel it all the way until the end, and return to safety. If you have diagnosed Post Traumatic Stress Disorder or Injury, I suggest you enlist the help of a registered therapist. (Important Blogger’s Note: I want to be clear that I am not a therapist, and anything I suggest is not a replacement of therapy.)
But for me, who did not have a formal PTSD diagnosis, journaling was the workhorse of my healing. Though writing a little bit of my story each day, and letting myself ruminate on it until that piece of the story felt “resolved,” I made huge strides in my healing. It is guided journaling as a technique that I want to share with other mamas struggling with their birth experience. I believe that the research and healing work I did should be given to other mamas so that they don’t have to wander through the wilderness as long as I did. It is something I did instinctively, and only found later paralleled that of Somatic Titration.
Now that you understand how the feeling of trauma comes to exist, you can begin to expand, very slowly, the feelings you feel around your hurt. I can help you do that — starting with my free excerpt, and soon with the complete text of Transforming Birth Trauma.
If you would like to know more about my journaling techniques, and work on your own healing, I invite you to get a free excerpt of my soon-to-be-released eBook, Transforming Birth Trauma. The sample contains two “tests” (aka journaling prompts) to determine if you’ve experienced Trauma, and the most important next step for claiming your birth story. And, once you’re on my mailing list, you’ll be among the first to know when the whole book is available for purchase.
Click here to receive The Transforming Birth Excerpt, ‘Two Tests to Be Sure It was Birth Trauma & the Most important next step,” and start reframing your pain.