Do you believe that birth is about more than just a healthy baby? Do you believe trauma could actually be our biggest teacher and conduit for personal and professional growth? Knowing how cope with vicarious trauma and develop sustainable self-care is a non negotiable for all birth workers. Join me, Doctor Erin Bowe, Clinical Perinatal Psychologist, as we uncover “who is helping the helper?”
My guest today is a testament to the value of good support and investing in yourself. To hear a strong woman articulate her trauma, to see and hear that she is not broken and is using her experiences as a conduit for others’ growth – well, that’s just my happy place. I will never tire of this privilege – what it means to receive these stories and have people trust me with them.
Rachael Rose is a full spectrum Dynamo doula hell-bent on bringing down toxic birth culture and supporting women to reconnect to their resilience and strength. Rachael is such a calm, sunny presence. I know this is a big topic, but you’ll walk away from this conversation feeling expanded rather than contracted.
We talk about what happens when a birthing person ticks that box and says “yes. I’ve had experience of sexual abuse”, and, in Rachael’s case what happens when it’s never spoken about again. What can we be doing to better serve people and give them choices, make them the expert in what they need to feel safe.
Sexual abuse, assault, molestation or whatever language we put to it must exist within a spectrum. It must never be about getting into comparisons and expecting people to qualify “does this count?”. It’s not a cognitive experience, it’s a bodily one.
Sometimes it’s not until you are a much older, or go through pregnancy and birth that you begin to think about some of the experiences you’ve had as a child. Applying the label of ‘sexual abuse’ is complex.
Rachael and I will talk about the impact of the abuse she experienced, but not go into detail as we are mindful of re-traumatisation. We talk about navigating all the bodily things - vaginal exams, stretch and sweeps, catheters, suppositories, language that is used, positions the body is put in. Having hands-on from other people when you’re learning to breastfeed. And then some of the anxieties that happen postpartum. Those intrusive thoughts that happen that are totally normal but no one ever wants to talk about.
As I’ve said before, the goal needs to be establishing safety, not getting the information.
You are more powerful than you know. If birthworkers and the people they serve remember that they are powerful, then we will change the world.
for the video version of this podcast: https://youtu.be/YlrPPbmpLcs
My Mini birth trauma training October round starts Thursday October 24
Link to secure your spot: https://doctorerin.as.me/
Link to details about the event https://business.facebook.com/events/558792318262055/?event_time_id=558792324928721
I have over a decade of experience working with survivors of sexual abuse and assault. If you want therapy or coaching around birth, trauma and managing burnout, reach out http://doctorerin.com.au/
Rachael’s website http://rachaelrose.com.au/
The Body Keeps the Score – Bessel van der Kolk
Lotus Fire – she’ll be on an upcoming episode 😊
Growth & self development
Today on the podcast I talk about failure, trying to force outcomes and trying again.
Dior had to try 150 times to make their next hit perfume for millennials. I haven’t given it a sniff so I don’t know how good it is, but it’s a great example of rethinking the “shouldn’t I be done with this by now?”
Trying to force yourself to be ‘healed’ or achieve some imagined level of growth isn’t going to work.
Maybe the universe has a better plan and the delays and roadblocks are actually there to help you?
I look back at jobs I didn’t get. Something I once thought of as a missed opportunity is now so clearly reframed as a dodged bullet. I can be pissed that I didn’t start working on some of my own traumas until after my children were born, or allow the idea that the timing wasn’t right.
Hope this reminds you that even the absolute best in the business have to try, again, adjust, be patient and try again until they get it right.
What do you think of when you hear the word ‘fistula?’
For me, it was 2004 and I was 21 years old. I was watching the Oprah show on my lunch break and she was interviewing Dr Catherine Hamlin. The image I have I my mind when I think obstetric fistula is of terrified, very young African women. Who has laboured for days without any support and is then ostracised from their community.
Very generally speaking, an obstetric fistula is a hole where a hole shouldn’t be. Between the vagina and rectum or bladder. It can be caused by prolonged or obstructive labour, leaving someone incontinent.
We might not want to admit it, but we sometimes think fistulas as something that doesn’t really happen in Western hospitals.
My guest today is someone who experienced such a birth injury in a hospital in the USA.
Kristin Hill is a mental health counsellor and mama of two boys in Seattle.
We talk about the feelings of patient-blaming, and scapegoating that goes on in birth. How it felt not finding any resources about fistula that particularly resonated.
The re-traumatising process of making a complaint while feeling like her body had been hijacked.
In sharing stories, we get our power back. We take ourselves out of isolation and shame and not only do we become stronger, we uplift others to see their own beauty and strength.
To listen to audio only via Apple
to watch on YouTube
The Emotional Freedom Technique (EFT or "tapping") has been around for a while. I learned it in my masters training 13 odd years ago, but then dismissed it. I allowed an old mentor to let me believe it was too "wu wu" and not scientific enough. Now that I've been working through some of my own old traumas and programming, I've come back to it.
I like it because it's something practical you can teach yourself (and your kids!). Tapping is like using psychological acupressure. By that, I mean it uses principles from Traditional Chinese Medicine where you stimulate meridian points. I LOVED using acupressure and acupuncture for pregnancy and birth, and we now have the MRI studies to show that the brain floods with endorphins.
Just about every form of therapy also uses coping statements, affirmations and positive self-talk. The way that we speak to ourselves impacts our subconscious, our confidence, the way we view our reality and thus shows up in every choice and every behaviour.
You can find the video demo on using tapping for this episode on my Youtube channel https://www.youtube.com/channel/UC3XrGmUmtMs3Rcs5IZ0MtSw
Episode 22 is also available in video format. Head on over to my YouTube Channel - https://www.youtube.com/watch?v=00eZ1R-fghE
I’d say that my guest today is like birth worker royalty, except that royalty typically represents a patriarchal system she’d hate. Instead, I will introduce her as a wild, wilful, wise woman. A goddess. A guru, the divine Jane Hardwicke Collings.
Often the best way to move on the path forward is to ask the wisdom of those coming back. Jane and I talk about the concept of “fish can’t see water”. The fish being birth workers in the patriarchal birthing system.
Jane is a women’s mysteries teacher. She began work as a midwife in the early 80s. She has seen, heard, touched, smelled and tasted trauma in the birth space. Jane is a visionary, and I know that so many of the messages she shares today will feel like she is giving you a direct call to action.
There’s no way forward for a midwife who wants to just be a good girl. Many of us are still operating from fear of persecution. Except instead of worrying about being burned and drowned we worry about AHPRA complaints.
You are more powerful than you know. If we can rewild midwives to remember that they and the people they serve are powerful, then we will change the world.
All resources mentioned are on my website http://doctorerin.com.au/podcast/
I’m always telling people to lean into the hard lessons. The lesson I’m in at the moment is learning not to keep pushing through sleep deprivation. The other thing I do is try to replace sleep with some other form of self-care. In this episode I’ll talk you through the ways in which I’ve struggled with self-compassion, and what work I’m currently doing to move from a place of seeking relief to finding joy xx
Now, one of my new favourite things to do on the podcast is interview a birth worker and then interview their mentor. So a few episodes ago I interviewed doula Hannah Goding, and now I’m interviewing her mentor Katherine Eden. In a few weeks I’ll then interview Katherine’s mentor and so on and so forth!
I love stories. This is why I do what I do, this is why I do this podcast. Sharing stories can be such soul medicine. I really do believe that as healers and helpers we cannot walk this path alone. We need support, a sounding board and a circle either physical or metaphorical for story telling.
Katherine is a great storyteller and a space holder. Always interested in the mystery of women’s bodies, pregnancy, and babies Katherine has dabbled in psychology, sociology, social work, and midwifery. She is now a doula educator who supports new doulas to thrive in every aspect of the sense.
Katherine and I chat about how to help the helpers. With trauma, with grief around the idea of what they thought birth work would be like versus how it actually was, and the bullying.
We talk about sister wounds, and the parallels of our work with adolescent girls and bullying and how we’ve been seen this transpire with adult women in midwifery!
If you resonate with fears of being told off, wanting to stay small so that you don’t get attacked, and maybe even a history of being bullied by other women – we are here for you!
Resources are on my website http://doctorerin.com.au/podcast/
What if there was a quick, effective way to move through processing the trauma of your own birth or witnessing it at work, and it didn’t involve going into loads of detail?
My guest today has specialist skills in how to do just that. Krysta Dancy is a licensed Marriage and Family Therapist in Roseville, California. She is also a Doula, so this is such a special combo.
I don’t think she will mind me saying that this is someone who is addicted to birth. Krysta worked as a therapist for 15 years had the same realisation that I have had – which is that birth trauma is the speciality that chose her
I was excited to talk to Krysta about her knowledge of EMDR. So if you’ve never heard of it, EMDR is a therapy approach that teaches the brain to process traumatic memories as if they are not traumatic.
The World Health Organisation recommends EMDR as one of the top two treatment options for trauma and PTSD. The other one is Cognitive Behaviour Therapy so I recommend you go and listen to that episode after this one, if you haven’t listened yet.
Now of course, these are two recommended approaches, not the only approaches. A huge value of mine in this work is helping people find holistic support options – both for birthing people, and for the workers who may be carrying vicarious trauma in their bodies. EMDR is a pretty cool approach though and I’m looking at getting trained in it myself. I know you’ll get a lot of value out of this episode so enjoy!
Krysta’s website with resources and referral options. She runs training, has a Facebook group for Perinatal Professionals. So does so much!
Cheryl Beck's book Traumatic Childbirth
Bessel Van Der Kolk's book The Body Keeps Score
In this episode I walk you though the difference between 'birth trauma' and Post Traumatic Stress Disorder from birth. When and how is it diagnosed, and when is it appropriate to seek general support and/or a self-help book and when might someone need more specialised, expert help.
My guest today, Kerrie Adams is an anarchist midwife. A system disruptor and an educator of modern, savvy midwives who also want to change the world.
Today We talk about:
Midwife archetypes – the “good girl”, the “bitch” and all the patriarchal discourse that creeps into our subconscious when we choose reaction or inaction
She talks about the differences between the UK and Australian systems. How it felt losing her autonomy and dropping skills. The culture shock of permission-asking and feeling like as a midwife there are people who want to keep you “stuck” at a certain level of skill, influence or even power.
Kerrie has an extraordinary vision – yet she describes a time when she literally lost her sight for ten minutes while she was working beyond capacity caring for 24 women.
We talk about how our lineage as birth workers is not one of confidence
Trace back to your own family history. If you find any women who in any way supported, healed or advocated for other women and children – they were called witches. They were burned and drowned. The epigenetics of fear of being seen is very real.
We talk about doing the inner work to create confidence, and truly learning the difference between passive, aggressive and assertive behaviour
The bystander effect that happens when witnessing obstetric violence and finding the confidence to say “I want you to stop” to someone who is causing harm.
How your values drive behaviour – how this can show up in things like not making yourself proper lunch. We make reference to the history of food and diet culture marketed to women – and all the shame, guilt and punishment that goes with it
This is all about moving from reaction and inaction to meaningful action
I want you to stay in birth work, if that’s your goal. Let’s talk about actionable steps to help make that happen.
Show notes on www.doctorerin.com.au/podcast
Australia’s nurses and midwives are overworked, under supported and in serious danger of burning out, with 32 per cent considering leaving the profession. This is according to findings of a Monash Business School survey of nurses and midwives’ wellbeing.
My guest today has found the confidence to work in a way that is aligned with her soul purpose, so that she’s not going to be another statistic.
If you want a sustainable career as a midwife, you need to actively level up your self-care and support. These are teachable skills. Hannah Willsmore is an Endorsed Midwife in private practice, a life coach and a buddy of mine from Hypnobirthing Australia. She is based in Adelaide, and runs childbirth education and women’s circles.
At fifteen years of age, Hannah managed to swing work experience in a hospital. She got into the labour ward and watched a cesarean birth. Can you imagine that ever happening now?!
With the spirit of knowing that midwives are so often just doing the best they can with shitty conditions, Hannah and I talk about how we can be preventing burnout and preventing birth trauma
We look at language- using person-centered language instead of medicalised language
Making things seem like an emergency when it’s not
And issues around Informed consent
We also talk about the importance of having a supportive network and not waiting until you’re stressed to seek support. If your support system doesn’t actually make you feel better and have you walking away lighter, then there’s something that needs some tweaks
I want you to stay in birth work, if that’s your goal. Let’s talk about actionable steps to help make that happen.
For all the resources and people mentioned, go to the podcast section of http://doctorerin.com.au/podcast/
Today’s episode begins an exciting series called ‘Midwives Rising’. This is where I interview bold, sassy, passionate midwives who are sick of being silenced. I talk to them about their experiences of vicarious trauma. About why people are so afraid of speaking up, and what needs to happen to change our birthing systems. Today I introduce you to the gorgeous Hannah Goding who is a Melbourne doula. We are looking at the false normalization of numbing that happens in midwifery and about Hannah’s journey from midwife to doula. Like so many of us do, Hannah got into birth work for the babies, the joy of new life and a fascination with pregnancy.
In her third year of studies, Hannah left after experiencing what she now knows was vicarious trauma. We talk about how the response of others around her was to numb out, not talk about it and keep going. An experience which left her feeling isolated and beginning to personalize what are actually very normal reactions to trauma. Vicarious trauma affected her spirit and her physical body– Hannah describes feeling so stressed that her periods stopped. Hannah describes that experience that I know so many of you have with that sentence “how could I be traumatized when I wasn’t the one going through it?” She talks about her experience of finding a psychologist to help her work through the trauma, and how to align her core values with her practice. She ultimately realized the impact she wanted to make in the world would be better served through doula work. We talk about what needs to happen to better prepare student midwives to better understand trauma-informed practice and self-care. We ask the question “what needs to happen in order for complaining to turn into actionable change?”
We discuss the gaslighting, bullying and hazing that goes on in the birth system. Where complaints go to the very people who are doing the damage. Where debriefs are turned into an opportunity to point fingers.
Resources (Full version www.doctorerin.com.au)
Hannah Goding https://www.instagram.com/hannahgoding_doula/
Hannah’s mentor Katherine Eden http://katherineeden.com/
Dynamo Doula training with Angela Gallo (which I teach in!) https://angelagallo.com/dynamo-doula-training/ Visibility for Visionaries (social media training) https://angelagallo.com/visibility-for-visionaries-social-media-training/
The Big Leap by Gay Henricks https://www.audible.com.au/ep/title?asin=B00FO5R7SY&source_code=M2MOR0003SH022414&ipRedirectOverride=true&ds_rl=1252280&gclid=Cj0KCQjw6IfoBRCiARIsAF6q06vfxPnkEeJjvqy-i-afQcv2Bd-BkDe2JRqtWMWSWf7VxxdF_e62jC8aAgQOEALw_wcB&gclsrc=aw.ds Newborn Mothers by Julia Jones https://www.amazon.com.au/
Why Induction Matters by Rachel Reed https://www.amazon.com.au/Why-Induction-Matters-Rachel-Reed/dp/1780666004/ref=asc_df_1780666004/?tag=googleshopdsk-22&linkCode=df0&hvadid=347623892579&hvpos=1o3&hvnetw=g&hvrand=7729168330667825124&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9071472&hvtargid=pla-592685430364&psc=1
Maybe you’re sitting in your car right now about to drive off from attending a horrendous birth. Maybe you are being bullied at work, or struggling with memories of your own birth.
We’ve all been in those situations where we are so overwhelmed that we can’t think of anything to do for ourselves to help decompress. In this episode I wanted to run through 5 things you can do right now that might help if the ideas are not coming to you.
1. Deep breathing activating the vagus nerve, and stretching out
2. Checking in with your thoughts – are they accurate? Can you activate the dorsolateral cortex and turn down the fight or flight response with coping statements – I’m going to be ok, I’m loved, what I do matters
3. Tapping and/or cupping your arms – bring some blood flow and energy back to your body. Sit and feel your cold keys on the back of your arm. You’re drawing your gentle awareness back to your body and the here and now. Try taking your shoes off and massage your feet. Or maybe your hands. Let the tension out.
Allow whatever feelings you have. Rather than try to push the feelings away see if you can name any feelings.
Are you willing to stop assuming that you know anything about anyone else’s experience until you have given them space to tell you?
In today’s episode I talk with Jenna Brown from love over fear wellness. Jenna is a change maker. A space holder. An eloquent, warm, vibrant presence that I am so glad exists in the world.
In today’s episode Jenna talks about how full spectrum doula work = trauma informed care
Trauma is really death by a thousand cuts – it’s not in one event, and for many, many people it’s interwoven with daily traumas.
Some of the things we talk about in today’s episode are:
being trans non binary in the birth world
why pregnancy and birth is not a celebration for everyone and how do we support people through pregnancy, birth, identity death and other forms of rebirth, death and loss
not making assumptions about people, and truly leaning into individual led care
how triggers are invitations for healing
00.09 the assumption that recipients of care will tell us about their gender, sexuality or past abuse
14.10 using a non-assumption approach
19.00 Why the rhetoric of “trust your instincts and your body in birth” doesn’t work for some people
21:33 the body as a harbinger as trauma – walking around in a suit of your own trauma as a trans person
31:15 why not everyone who is pregnant is a woman
38:00 How learning about gender and sexuality and attraction teaches you something about yourself
41:00 Some basic stats about discrimination of trans people
43:48 How systems use shame to influence behaviour
51:40 using a safety plan for your self-care so that you don’t get stressed and then get stuck in inaction.
55:00 redefining being an ally
Permission to be dynamic and need different things in different moments
How love and a desire for compassion and enriching our lives with diversity is the killer for fear
IG and FB handle:
Queer and Pregnant journal
Glossary for providers:
Resource for inclusive birth professionals, includes many links to continued education opportunities:
One story, of many:
Without wanting to simplify maternal mental health assessment in ANY way shape or form, I wanted to share one of the key questions I use in differentiating anxiety from psychosis. New parents are already struggling with hormones, sleep deprivation, poor eating and heightened stress. Many are terrified to tell anyone about their distressing thoughts for fear they will be 'locked up' or their baby taken away. This simple question could potentially make a difference in someone's care, their experience of mental health clinicians and their life.
Remember to slay in your lane! This is not about teaching differential diagnosis, nor should you be attempting to make decisions about the mental health of someone else unless you are suitably trained. However, there are many times where health professionals forget to actually look at the person in front of them instead of responding to familiar symptoms/stories/programming.
You have no idea how excited I was to speak with Erika Cramer. For a psychologist slightly obsessed with other people’s growth from pain and trauma, talking to Erika was SO deeply satisfying for the soul. To describe Erika as a fiery confidence coach doesn’t even cut it. Goddess Kali herself would see Erika out the corner of her eye and question what “powerful” means. If you don’t like Goddess culture, then let me put it in scientific terms – Erika is an outlier. Like eye wateringly way, way outside the curve of “expected” and I LOVE her so, so much because of it.
The amount of trauma this warrior woman has been through is off the scale. And yet here she is – having done the work, and continues to do the work on herself so that she can give to others. A self-described “ghetto Boston bitch” there is no bullshitting with Erika. She is the most gorgeous example for women of reframing “bossy” into being a justice-doing activist.
If you are struggling with anything and rehearsing ANY of these old stories: “it’s too late”, “it’s too hard to change”, “therapy is too expensive”, “I’m not ready”, “time heals all wounds” or whatever else you’re using as reasons not to dive into your growth – I hope you come away from Erika’s story feeling different.
Erika talks about
· Finding confidence from healing your own trauma
· How you can’t possibly inoculate yourself from all traumas. Accepting that trauma will come and trusting yourself to grow from it
· Erika’s experience of having a Mum with severe Bipolar Disorder, foster care, repeated sexual abuse, re-learning to walk after a horrific car crash, losing her husband after another horrific car crash, and having a dog who died in birth
· The journey from being someone who, at 18 thought “I’ll just get the baby cut out” through to being an advocate for home birth
· Working her way through judgement of other people and their birth choices through to letting go of “shoulds”
· The infinite possibilities of birth and letting go of expectation in birth to intention.
· Healing from a traumatic c-section birth through to a VBAC at home
· Using gratitude and connection from your trauma (e.g., “ok so now I can connect with women who’ve miscarried)
· Using bodywork through working on her hips and being in the moment to heal miscarriage, grief and emotional pain stored in her body
· Her hero’s journey from a “non-brochure” traumatic first birth through to working her arse off for a satisfying second birth
· A client’s perspective of how birth workers can forget what it’s like to be a client, and how it feels when your care provider isn’t confident
· The experiences of being told you’ve “failed to progress”, that “you’ll leave the hospital without a living baby if you don’t do X”, and that your first birth was “too crazy” for homebirth to be a good option
· The unpleasantness of proper self-care and how uncomfortable you need to get to do the work on yourself
· If you’re not going to pay someone to work on your own shit, why would anyone pay you to support them?
Byron Katie - Loving What Is: Four Questions that can Change Your Life
Breastfeeding trauma is often overlooked. It can represent a continuation of traumatic birth, come up as a new trauma in and of itself, or it can trigger previous abuse or unpleasant associations and memories with our own bodies.
With my first baby I really struggled. I managed to exclusively pump, but after 6-7 months I’d had enough. With my second baby, we’re about to hit 18 months of breastfeeding, and I have to pinch myself.
Today I interview my breastfeeding angel, Amberley Harris. Amberley is a breastfeeding consultant and registered Midwife. She absolutely changed my life.
In this episode, Amberley and I unpack some of the major differences between my first and second breastfeeding experiences and how breastfeeding can represent a continuation of traumatic birth.
Breastfeeding can trigger huge feelings of failure, shame, self-doubt, guilt, and crushing sense of bodily autonomy.
In today’s episode we cover:
· Common breastfeeding myths and negative story-telling handed down through families
· Self-fulfilling prophecies and the language that’s used (e.g., having ‘flat nipples’, or being pale = definite nipple damage)
· How we can teach birthing people about the ways in which certain interventions (medications, scalp clips, c-section) may impact breastfeeding
· Empowerment that can come from learning to express antenatally
· How we can encourage birthing people to make a breastfeeding plan rather than waiting to get help if things get difficult
· How less than 5 percent of women actually have insufficient milk supply (due to insufficient glandular tissue). There are SO many other factors contributing to difficulties with breastfeeding
· What’s a “normal” amount of pain with breastfeeding? How do we measure it? What happens to us when we’re told “but the latch looks ok”
· How you can help at that first feed. Skills for calming Mum and baby
· The benefits of time and patience. The breast crawl is replicable for months. If the first time doesn’t work out, there’s still time to encourage babies to use their instincts
· The idea that ‘her success is not your failure’. Talking positively about breastfeeding while being mindful that one person’s celebration can trigger someone else’s shame
· How I used the ‘4P’ analysis to put together a breastfeeding history and find the predisposing, protective, perpetuating and protective factors.
You can see the handout I used about applying the ‘4 P’ analysis to my breastfeeding history on the website www.doctorerin.com.au/podcast
Diabetes and Antenatal Milk Expressing
Jenna Kutcher’s podcast
There’s also a chapter on breastfeeding trauma in the book Traumatic Childbirth
Have you watched that documentary from Brene Brown on Netflix yet? So many take always but a huge one for me was this – to not have conversations just because they make you feel uncomfortable is the definition of privilege. In the majority of birth culture we talk about birth through a hetero lens. As a white, heterosexual woman who has birthed at a hospital I’ve never had to stop and think about whether or not I look like the people in the brochure. I’ve never had to worry about whether someone will make inaccurate assumptions about my identity, my sexuality or make assumptions about my partner.
We all have biases. One of mine has been the familiar story of “well I’m super accepting of LGBTQIA+ clients, so that’s enough”.
I’m inviting you today to be courageous and admit that there’s a whole lot you don’t know about what you don’t know. I want you to embrace feeling uncomfortable, because (a) we must have uncomfortable conversations in order to see real social change, and (b) unless you are fighting for your birth rights within the LGBTQIA+ arena, your comfort is not really the centre of these conversations.
Feeling uncomfortable is how we do the work of trauma. If you sit with your discomfort it can take you to such an amazing place of growth, insight and strength.
Sheridon is a Melbourne Doula who also works in the community sector delivering juicy trainings. She sings, she plays the drums, she loves high fashion and I am SO glad we met! Some of the topics we cover in today’s episode:
Learning about diversity is a win/win. It’s joyful and reminds us of our core values about equality, love and humanity.
We need more than just whacking up a rainbow sticker. How does it feel when you navigate the world not knowing if you are welcome or not
How to bring an intersectional lens to your work remembering that LGBTQIA+ families are still grappling with erasure, pathologizing and loads of intergenerational trauma
Joy is a killer of fear
Language is a moveable feast - It’s not about being ‘right’. It’s about being open, reflective and allowing the birthing person and their family to guide us in what they need.
You can be an expert in your field but you’re not an expert on your client’s experience. It’s not yours to be an expert in.
To think about lifelong learning versus being “done” with training
Checking in with what you don’t know you don’t know about LGBTQIA+
Gender bread person
Vikki Reynolds self-care and how not to burn out in justice doing work
How to work with burnout and oppression
In episode 8, I talk you through the pros and cons of using CBT for birth trauma and how it's less about the therapy approach you choose and more about the therapeutic fit.
The WHO recommends two main Psychological approaches for the treatment of Posttraumatic Stress Disorder (PTSD). One is Cognitive Behaviour Therapy (CBT) the other is Eye Movement Desensitisation & Reprocessing (EMDR).
Cognitive Behaviour works by working with someone's negative or 'stuck' thoughts about the trauma. This works on the idea that the brain doesn't realise that the threat of the trauma has passed, and/or what you want to do with information about the trauma. Imagine that somewhere in your birth experience (or watching someone's else's) you have the thought "this is it, I'm going to die". I remember in vivid detail after the birth of my first daughter being in so much pain, that I actually welcomed death. I remember being wheeled off to emergency surgery seeing my husband cradling our new baby and saying thinking "take care of her. This might be the last time I see you guys". I still well up with tears every single time I think, write, or speak about it, but part of the 'trick' to coping has been (a) realising I had that thought and (b) coaching my brain to realise that the threat has past, and I'm now in the present. Each time I'm able to do that, my heart rate lowers, my breathing rate reduces, my jaw relaxes and I can feel what it's like for my brain to back down, realising it's a memory and the actual threat has passed.
The goal of CBT then is to help people catch the negative thoughts that pop up automatically and thereby reduce the awful feelings. CBT posits that all feelings and sensations from trauma (e.g., heart racing, sweating, feeling pannicky, feeling rage, avoiding) all start with a single thought.
A large component (at least the way I work) is through writing – writing the event as it happened, in the past then in present and working with ‘hot spots’ – automatic negative thoughts. The goal is to work with thoughts and beliefs about the trauma so distress is reduced.
PROS of CBT
Medicare rebate supported (10 sessions in Australia)
Skills learned translate well into other areas of life - confidence, parenting, anxiety, depression, fears and just getting yourself out of a funk.
Easy to find a practitioner
CONS of CBT
Potentially the ‘best’ we have but still doesn’t remedy all PTSD
Gold standard CBT for PTSD is 20+ sessions, roughly 12 months of work
Medicare will only rebate for 10 sessions, meaning client either has to fork over the rest of payment, wait until new calendar year, or find bulk-billing (there are no financial benefits for mental health workers to bulk-bill, unlike for GPs)
Can potentially be interpreted as blaming (‘your thoughts are the problem’)
Even imaginal exposure is too confronting for some
Cognitive therapies are not great for people with low self-reflection
Nisha Gill of Feminine Instincts is a Melbourne-based Somatic Experiencing (trauma resolution) Practitioner with a background in counselling, bodywork, birth education, doula support, feminine embodiment yoga and birth hypnosis.
She specializes in birth and sexual trauma resolution via a neurophysiological approach which focuses on safety and capacity at the level of the autonomic nervous system. The approach also lends itself to preparing for birth when paired with bodywork to simulate labour and increase the birthing person’s threshold to stress and trauma responses.
Nisha works with individuals in therapy and groups for trauma education both in person and online.
In this episode we talk about:
1. How we are still very much primal beings and our trauma responses as humans are not that different to animals
2. Trauma as an incomplete nervous system response. How is trauma stored in the body even from a time when we were preverbal
3. Why we don’t necessarily need to ‘remember’ the content of our traumas in order to work with them
4. How to scan and listen to your body – where are the niggles? where do you feel stuck? How to we build in new calm and/or pleasant experiences and sensations
5. What can you do to resettle your nervous system if you can’t leave the space?
6. What does a session with a Somatic Experiencing practitioner look like? How to open your mind AND open your pelvis!
Nisha’s Birth Trauma Awareness Facebook Group
The Tao of Trauma: A Practitioner's Guide for Integrating Five Element Theory and Trauma Treatment Paperback
Alaine D. Duncan, Kathy L. Kain, & M.D. Michael Hollifield
You can find Grace & Frankie on Netflix
Further info www.doctorerin.com.au
Have you ever met the perfect person at the perfect time who completely changed your life? Angela Gallo is that person for me.
She is a collector of animals. A collector of tattoos. A snorty laugher, a generous gesticulator, and when she walks into a room you have to double check if you can hear the Rocky theme song playing in the background.
She is an identity death doula, a curator of postpartum experiences with purpose. She teaches doulas how to excavate their soul so that they can consciously show up for clients.
In today's episode we talk about
Our shared experience of birth trauma. What she learned from watching me go through a traumatic birth with severe shoulder dystocia my daughter, Lily. How we have both grown stronger and more resilient because of this experience.
We talk about this idea of what you don’t know you don’t know and that when that unknown is suddenly presented to you – how you can run and fight it or face it. You might find it hard to believe, but Angela is someone who has avoided feeling big feelings for along time. It is through her own excavation of her own demons that she has been able to step up, be seen, and be fully present in mind, body and spirit for her clients.
As birth workers we so often have a narrative of being rewarded for nurturing others. We gain a sense of self-worth and value from caring for others. Many of us even tell ourselves that beautiful lie – that by helping others with their trauma, we are healing ourselves vicariously. No, you’re not. You need to do the work on your own stuff. You need to show up and be fully present in your own body, doing your own work before you can be a container for someone else. Angela and I both feel this to be the uncomfortable truth because we’ve lived it. Are still living it! The discomfort of working on yourself is never done. We are always learning.
We talk in pictures so there’s a metaphor of proper self-care being like taking a bath in diarrhoea. Because, really, doing the work that you need to do to get strong as a birth worker is seriously uncomfortable. But if you can wade through it Slumdog Millionaire style – you are going to be SO fucking strong.
Emily Graham and Carey Glenn
Meg Berryman is an empowerment coach and yoga teacher who previously worked in the international development sector. In this episode, we talk birth and maternity care in the Gaza Strip, Timor and Africa, and how she has coped with aid worker guilt. Meg also discusses how burnout, Adrenal exhaustion and auto immune disease was a catalyst for resilience and growth. We talk about trauma narratives, embodiment work and what some of her daily, practical self-care practice looks like.
Start here! A brief introduction about my own traumatic births, my training as a Clinical Perinatal Psychologist and how working with my Doula propelled me to find my purpose. That purpose is all about supporting perinatal professionals to feel empowered with trauma training, emotional first aid and sustainable self-care practices.