Developing a healthy sex life after sexual abuse/assault: Part 2, Remedies
This article will talk about some skills and strategies to heal the traumatized part of your brain and to move toward the intimacy you deserve. If you missed the last article that talks about the ways that experiences of sexual abuse/assault impact intimacy and sexuality, I’d recommend going back and reading that article before beginning this one.
Every nervous system is a little different, so what works for one person may not work for another. There are many options for healing trauma and developing a healthy intimate and sex life, so I encourage you to choose options that resonate best with you.
Shift Ideas about Sex
A good place to start might be with the ideas you and your partner(s) hold about sex. Often survivors hold negative beliefs about sex that have resulted from parts of our brains confusing sexual assault (violence) with sex (consent, pleasure, equality). The two are not the same, and we need to rewire our brains to reflect this. I recommend having a look at Wendy Maltz’s comparisons chart here https://healthysex.com/healthy-sexuality/part-one-understanding/comparisons-chart/ to get an idea of the difference between ideas about sex that come from experiences of abuse, versus healthy ideas about sex.
You can continue to develop a healthy sexual mindset by avoiding media that portrays sex as abuse, talking about sexual attitudes with friends or with a therapist, and educating yourself about sexuality and healing through books and workshops. One book I strongly recommend is Come as You Are by Emily Nagostsky
Communication with Partners
This may be the most important recommendation in this article. You cannot have consensual sex without communicating about it and that’s true for anyone, whether they’re an assault survivor or not. The problem is that sex remains a taboo subject in our culture, even though sex is very normal and most people have some form of sex at some point in their lives. When things are taboo and not widely talked about and understood, people develop feelings of shame about the taboo subject. Shame lurks in the darkness. This feeling of shame or embarrassment or even just awkwardness keeps many people from talking about sex with their partners despite engaging in sex.
1. Consent is dynamic: It can be given and withdrawn at any time
All people, and especially survivors of assault/abuse need to be able to give and withdraw consent AT ANY TIME during a sexual or intimate act. Many survivors will experience flashbacks or triggers at various times through physical or sexual activities and because they don’t feel safe to tell their partner to stop (often out of fear for making them feel bad), they will instead dissociate and push through the sexual experience. When you do this, you are telling your brain and body that what you feel doesn’t matter and that the other person’s pleasure or comfort is more important. And while it may feel frustrating to have to stop mid-sex or mid-kiss or mid-hug because something has triggered you, listening to your body will actually help the healing process go much faster. Each time you override what your brain and body needs, the trauma gets reinforced and the triggers continue to come back. Slower is faster when healing from trauma. This is something partners need to understand. If a survivor is saying no, it’s because they trust you enough to say no, not because they’re not attracted to you. Every “no” is sexy because it’s getting you closer to an enthusiastic, consensual “yes”
2. Understand and Communicate your preferences
In addition to understanding and respecting the need to withdraw consent at any time, it’s important to talk about sexual preferences. What feels good, what feels neutral and what doesn’t feel good. Communicate when something felt uncomfortable and explore together to find what does feel comfortable. When sex is approached with curiosity and exploration rather than rigidness and shame, it becomes increasingly safe and pleasurable for both parties.
3. The need to take a break
Sometimes survivors of sexual abuse and assault may need to take a prolonged break from sexual activity. This can happen when the individual is in a relationship or not. The break allows space to focus on healing and figuring out what feels good and what doesn’t without worrying about the anxiety of managing their partner’s advances. When you are ready to engage in sexual activity again, do so when you want it, not when you believe you “should.” You have a right to be an active participant in your own sex life. Communicate your likes and dislikes and give yourself permission to say no at any time.
How to Manage Triggers and Flashbacks
As mentioned above, some survivors will experience triggers or flashbacks during physical touch or sexual activity. Flashbacks and triggers are often thought of as images of the traumatic experience, but they can also be experienced as unpleasant sensations, or a lack of sensation, an experience of disconnection, or an experience of overwhelm. When this happens it’s important to stop whatever is triggering the flashback, i.e. stopping the sexual activity or the physical touch. When you have a flashback, a part of your brain thinks it is in the past when the trauma happened, you need to remind that part of your brain that you are in the present moment and that the danger has passed. Another word for this is “grounding.”
Grounding Strategies/Orienting back to the present moment
· 5,4,3,2,1
Name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, 1 you can taste
· Deep breaths
Breathe in for 4, hold for 7, out for 8 (or any variation of that where you breathe out longer than you breathe in, this slows down your heart rate)
· Box breaths: in for 4, hold for 4, out for 4, hold for 4 (repeat 4 times)
· Stand up and move your body – get the adrenaline out
Run on the spot, go for a walk, jumping jacks
· Watch youtube video that makes you laugh (laughter is grounding)
· Play a categories game
· Say the alphabet backwards
· Show these strategies to your partner and do them together
Once you’ve successfully grounded (and give yourself as much time as your nervous system needs for this, remember slower is faster), take some time to rest and find comforts, your nervous system has just gone through a lot. It can also be good to think about what triggered you and to discuss with you partner how to change that in the future. You may want the help of a counsellor to determine this.
Counselling
Trauma counselling can really help you to overcome the impacts the trauma has on your life. You may also want to incorporate some couples counselling to help improve communication so that the two of you can work as a team on this.
There are 3 types of trauma counselling that can be beneficial. You may benefit from a mix of all three
1. “Top-Down” counselling:
This type of counselling helps you to change the thought patterns and behavioural habits that have formed as a result of the trauma. You will learn to notice the emotions and to change the behaviours and thoughts that tend to come as a result of the emotions. Some examples of this include CBT and DBT.
2. “Bottom-Up”/Somatic Counselling:
Emotions and survival responses are physiological. You may notice a tightness in your chest when you feel anxious, a lump in your throat when you feel sad, a pit in your stomach when you feel embarrassed, or any variety of physical manifestations of emotions. This is because when we feel an emotion our bodies are automatically mobilized to do something with it. For example, if you see a grizzly bear, your body might instinctively run or freeze or even try to fight it, you don’t even have to think about it, your brain does it automatically. Your body also knows how to heal from the trauma, but often circumstances prevent us from being able to allow our bodies to do what they need to do. Bottom-up counselling approaches such as EMDR, Sensorimotor Psychotherapy, or Somatic Experiencing can help you to process the trauma by mindfully allowing your body and brain to do what it needs to do to heal. This will also greatly improve your relationship to your body
3. Mindfulness Counselling or Practices
Through mindfulness practices you can train your nervous system (brain and body) to become fully present, and to notice when triggers are happening while keeping a foot in the present-moment so that you don’t become overwhelmed. With mindfulness you can learn to allow emotions to come and go naturally without being swept away. If you’d like to start mindfulness on your own I’d recommend starting with short 2 minute practices and slowly working your way up. Examples of mindfulness-based counselling include Mindfulness Based Cognitive Therapy and Mindfulness Based Stress Reduction.
I hope these tidbits can help you get started, or to continue on your healing journey. You deserve a healthy intimate life that includes boundaries, consent, pleasure and joy. Slower is faster; trauma takes time to work through, but it is very treatable, and you don’t have to do it alone.
Sources
Maltz, Wendy (2021). Healthy Sex: Promoting Healthy, Loving Sex and Intimacy. https://healthysex.com/
Nagoski, Emily (2015). Come as you Are: The Surprising New Science that will Transform your Sex Life. Simon & Schuster Inc: New York.
University of Alberta Sexual Assault Center (2019). Sexual intimacy after sexual assault or sexual abuse. https://www.ualberta.ca/media-library/ualberta/current-students/sexual-assault-centre/pdf-resources-and-handouts/intimacy-after-sexual-assault-2019.pdf
Developing a healthy sex life after sexual abuse/assault: Part 1: Understanding the Impacts
Note: This article speaks in broad terms about sexual assault and abuse. If you feel overwhelmed at any point reading this article, I encourage you to stop reading (or skip to the section on “grounding”) and allow your body to do what it needs to do to come back to the present, whether it’s going for a brisk walk, doing some deep breathing, or calling a trusted friend. As this article will discuss, there’s no need to push yourself past the point of overwhelm, healing can only take place with patience.
Many survivors of sexual assault face difficulties with intimacy and/or sexuality at some point in their lives. While this is a very common experience, it’s certainly not the case for all survivors. Traumatic events affect people in a variety of different ways dependent on each person’s life experiences and their unique nervous systems. This article will focus on the people who do struggle with sex and intimacy after traumatic events and will show that even though it can feel really hopeless at times, there are some amazing ways forward to achieving a healthy and satisfying sex life. We have some powerful innate abilities to heal trauma, but it often takes patience, support and work to get there.
Understanding the Impacts
Sexuality and the Central Nervous System – Stress and Love
Sexuality is impacted by the emotional systems managed by a very primal part of your brain often called “the reptilian brain.” This part of your brain is responsible for stress feelings as well as love feelings, all of which have helped us to survive as a species. Stress and love are also the main emotions that impact intimacy and sexual desire.
Stress responses are the neurobiological processes that help you deal with threats. Your brain prioritizes one of the following three main components based on survival needs: fight (anger/frustration), flight (fear/anxiety), or collapse (numbness, depression, dissociation).
Love is also a survival strategy; it’s the neurobiological process that pulls us closer to our tribes and bonds humans together. It’s responsible for passion, romance, and joy. It’s also responsible for the agony of grief and heartbreak.
When a person lives through a traumatic event, the stress response in their central nervous system (brain and body) often gets locked into survival mode. It has detected that there is danger and so it learns that it must always be scanning for any sign of danger. As a result, there are two very common reactions to sexual trauma that affect a survivor’s sex life.
1. Sexual Avoidance/Difficulty Experiencing Pleasure
The main function of the central nervous system is to prioritize survival needs in order of importance. For example, if you can’t breathe, you’re unlikely to notice that you’re hungry until you get oxygen again. Similarly, although love is indeed a survival mechanism (brining us together with our tribes), the brain tends to prioritize attention to stress over love because stress points to a more immediate threat: the possibility of another dangerous and violent act.
After a sexual assault, sensations, contexts and ideas that used to be interpreted as sexually relevant (like physical touch) may instead now be interpreted by your brain as threats – so sexual situations actually make your brain sound the “danger” alarm bell. Our central nervous systems confuse sex (an act of consent, equality and pleasure) with sexual assault (an act of violence and power over another). Remember, your nervous system’s primary function is to keep you alive and safe, so anything that feels in any way similar to a violent situation from the past will sound your brain’s alarm bell.
Basically, you may be experiencing love or desire, but your brain is still stuck on survival mode which makes it almost impossible to experience pleasure, desire and closeness.
2. Engaging in Compulsive Sexual Behaviours
Remember how love is also a survival strategy? It draws us closer to others and makes us feel whole. So instead of stress hitting the sexual breaks, some people get locked into patterns of feeling out of control sexually and having multiple partners. In this case, sometimes the innate survival strategy prioritizes closeness for that feeling of being whole; however, when this is a survival mechanism, it’s often happening from that “collapse” stress response, or a more dissociated place. People stuck in this pattern may experience a brief feeling of relief but may still struggle with the deeper components of intimacy.
3. Additional common symptoms
· sexual avoidance/anxiety
· sex feeling like an obligation
· dissociation during sexual activity/not present
· negative feelings associated with touch
· difficulty achieving arousal/sensation
· feeling emotionally distant
· flashbacks/intrusive thoughts or images during sexual activity
· engaging in compulsive sexual behaviours
· difficulty maintaining an intimate relationship
· vaginal pain in women; erectile dysfunction in men
· feelings of shame
· negative beliefs about sex
This is a short list of reactions, there are many more impacts on a person’s sense of self and experiences in relationships. If you’d like to get a better sense of how your traumatic experiences may have impacted your sex life, you can have a look at Wendy Maltz’s Sexual Effects Inventory here https://www.havoca.org/survivors/sexuality/sexual-effects-inventory/
Remedies
This short article was just to give you an idea of some of the many ways that sexual assault can impact intimacy. These impacts sometimes show up directly after the assault and sometimes show up years later.
Stay tuned for the next article which will talk about some of the many ways to heal the parts of your brain that are impacted by the trauma and to help you to find safety and pleasure in intimacy.
Sources
Maltz, Wendy (2021). Healthy Sex: Promoting Healthy, Loving Sex and Intimacy. https://healthysex.com/
Nagoski, Emily (2015). Come as you Are: The Surprising New Science that will Transform your Sex Life. Simon & Schuster Inc: New York.
University of Alberta Sexual Assault Center (2019). Sexual intimacy after sexual assault or sexual abuse. https://www.ualberta.ca/media-library/ualberta/current-students/sexual-assault-centre/pdf-resources-and-handouts/intimacy-after-sexual-assault-2019.pdf
How to Manage Stress
We’re often told to reduce our stress by taking on fewer responsibilities when we’re feeling overwhelmed. That certainly can help, but what’s more important is to learn to move through the stress response cycle so that when we are faced with stressor’s our bodies have the capacity to handle them. This requires learning to listen to our bodies and our emotions
Don’t Confuse the Stressor with the Stress
A stressor is something that causes stress, such as a semester of school. Stress is that feeling of fight, flight or freeze. Often, we believe that we’ll feel less stressed once we’ve dealt with the stressor. I often tell myself that when the next term at school is over, I’ll feel energized and happy again. Then, the end of term comes and after a week I notice I’m still feeling exhausted and irritable. This is because I was confusing the stressor with the stress. The stressor may be long gone and successfully conquered, but the reason I still feel irritable and exhausted is because my body hasn’t moved through the stress response cycle and come out the other side. Can you relate? Let me explain. (Nagoski, 2015).
Stress-Response Cycle: Listening to our Bodies
Our body’s natural tendency in times of stress is to move through the beginning, middle and end of our response to stress. When we are in fight, flight or freeze, a lot of adrenaline is pumping through our bodies. Our body’s natural tendency is to find a way to expend that energy. With fight, it would be throwing punches, flight would be to run, and even in freeze, our natural tendency when we come out of freeze is to shake. Once we’ve expended that energy, our natural tendency is to find safety and to rest. This is the full cycle: trigger (beginning); energy expending (middle); safety and rest (end) (Nagoski, 2015).
Unfortunately, in our culture we’ve been taught to suppress the messages we get from our bodies. Our culture is uncomfortable with feelings and so we’re told to suck it up; we’re told that everyone is stressed and that’s just what life is. We override our body’s messages because they’re not always compatible with work or with the social context at hand. When we keep overriding the messages our bodies send us, our bodies because stuck in a state of stress. When we never feel like we can escape the feeling of stress, we start to cope in ways that are less healthy, such as developing addictions or lashing out at people when we don’t mean to. There’s so much pent up energy and it hasn’t had a chance to move through us (Nagoski, 2015; Van Der Kolk, 2015).
How to Complete the Cycle
We probably don’t want to be fighting people when we’re stuck in traffic or running out of our cars after a car veers into our lane. But there are more practical ways to complete the stress-response cycle.
The Middle Part of the Cycle: (The part where you let the energy out)
Physical activity: Helps to re-calibrate the nervous system. It lets your body complete the middle part of the cycle and expend all that adrenaline that was secreted from the various stress-related triggers in your life. Any kind of physical activity will do, as long as it gets you moving and gets your heart-rate up.
Allow yourself to have a good cry or a primal scream. The kind of cry where you sob for 10 minutes and then heave a big sigh of relief. This lets the emotion move through you instead of getting trapped in your body.
Journaling: Writing your thoughts down can sometimes offer a feeling of release and relief. You can keep an ongoing journal of your thoughts and feelings and/or you can write them down and then rip them up. The act of ripping up the pages can also be relieving.
Art: Finding creative ways to express emotion and dispel stress
The End of the Cycle: (The part where you rest)
Seeking affection from someone you trust: Proven to be a very effective way to calm down the nervous system
Identify people and places that you can trust to provide space for you to feel your feels
Sleep: Do what you can to prioritize it, and seek help from a doctor and/or counsellor when you’re having consistent trouble sleeping
Grooming: For some it can be meditative and give a feeling of self-care
Engaging in anything you find comforting
Throughout the Cycle:
Mindfulness: Start cultivating a mindfulness practice, even if you start out with just one minute per day.
Mindfulness allows us to notice what we’re focusing on, notice what we’re feeling and then have agency in deciding what we want to focus on and how we want to express that feeling.
https://www.headspace.com/ is an app that offers a free mindfulness series to get you started, and the app allows you to start with mindfulness exercises as short, or as long as you want.
Counselling: A counsellor can help you learn to move through your stress response cycle in a way that feels right for you. They can also help you to make sense of stress responses and emotions that feel confusing and stuck.
Remember, this can be very difficult, especially if you’ve grown up in a culture that teaches you to suppress your feelings and your body’s signals.
The most important part of moving through the stress response cycle is to be patient and kind with yourself. You’re learning something new, it takes time and you don’t need to do it alone.
References
Nagoski, E. (2015). Come as you are: The surprising new science that will transform your sex
life. Simon & Schuster: New York, NY.
Van Der Kolk, B. (2015). The body keeps the score: Brain, mind, and body in the healing of
trauma. Penguin Books: New York, NY
How to make better decisions
Hint: Emotions are just as Important as Rational Thinking in Decision-Making
Seems counterintuitive right? How could it be that those seemingly irrational, often painful internal reactions (emotions) have any business in the world of rational decision making?
Many of us have accepted the tradition of believing that reason is the best guide to decision making and that emotions are a nuisance that needs to either be controlled or vented to get them out of the way of higher rational thinking.1
The truth is that we’re all much smarter than our intellects alone!1 Our emotions are a big part of the reason our species has survived for so long. Rational thinking helps us to thrive, but without emotions, we wouldn’t survive.2
For example, as Marsha Linehan, the founder of Dialectical Behaviour Therapy says, “if you decided to never feel afraid again, you’d end up dead pretty fast.”3 You wouldn’t know to avoid dark alleys that seem dangerous. Your rational mind may have heard some news reports on muggings in dark alleys, but without your fear response, you’d be unlikely to apply those warnings into your own life. First, if you feel some fear when listening to the news reports on dark alleys, your brain integrates the warning into memory much quicker and much more effectively than a piece of information that doesn’t generate any emotion. Second, when you approach the dark alley, you might feel some feeling in your gut or a physical instinct to run away from it. This is your fear emotion popping up to quickly remind you to stay away from an important source of potential danger. Once you feel that sensation in your gut or that urge to run, you can then integrate it with your rational thought (which happens much slower than your emotion brain) and determine whether it’s best to go through the dark alleyway or to go around it.
Humans are wired to integrate both emotional guidance with rational thinking. The trouble is that in Western culture, we’ve been taught to dismiss the important messages our emotions send us.
THE MIDDLE PATH: INTEGRATING EMOTION WITH RATIONALITY
Think of yourself on a canoe, travelling down the river. Over by the right bank of the river are the rapids (your emotion brain) and over by the left side, the river is really shallow (your rational brain). If you veer into the left, rational side of the river, you become reefed and your boat can’t go anywhere. But if you veer into the right side of the river you move too fast and out of control because you’re caught in the rapids! Dan Siegel calls these the “chaos and rigidity banks.”2
Life on the Rigidity Bank
We get stuck on the rigidity bank because without emotions we wouldn’t be motivated to do anything.
Think of the word E-motion – emotions move and guide us. “E” stands for energy, and motion directs us to act on our feelings. Some feelings are full of energy, like anger or fear. These high energy emotions guide us to act to protect ourselves or someone we care about. Other feelings like sadness or shame are very low energy. They guide us to pull back and take time to determine what our next steps should be in the face of a painful situation like losing a loved one. Emotions help us to determine what we need in each moment. The more we understand what we feel and how to move through those feelings, the more likely we can befriend our feelings and allow them to integrate into our everyday rational life.
Furthermore, to stay on the rigidity bank, we have to push our emotions aside, and I’m sure many of us have experienced the way emotions tend to come back with a vengeance when we haven’t listened to them. Life stuck on the rigidity bank simply isn’t realistic long-term, there’s nowhere to go. 1, 2
The Life of the Chaos Bank
On the other hand, if we’re caught in the rapids, we may have a sense of what we need but it’s much harder to determine how to responsibly execute it in a way that will be beneficial to us and to others.2
Remember the question of whether or not to go through the dark alley? If we’re stuck on the chaos bank, then we might run away and panic and have no idea why. When we veer back toward the centre of the river, we can remember some of the reasons that we might have felt that fear and then we can take a look around and determine how to feel safe again.
Floating Down the Centre of the River: Integration
The key to integrating our emotion mind with our rational mind is to remember to take a step back and give ourselves some time. Our emotion mind will tell us what we are needing in the situation, and our rational mind will remind us of what’s realistic.1,2
HOW TO PRACTICE INTEGRATING EMOTION AND REASON
Take a moment right now to be curious about what you’re feeling in your body; maybe you feel some tightness in your chest, some heaviness in your eyes or even a pit in your stomach. That’s where your emotions are sitting. In other words, when you have a “gut feeling,” your body is trying to tell you something important and you need to take a moment to listen to it.1
It might be really uncomfortable at first, but if you start noticing what’s happening in your body at any given time, you’ll also start having a better sense of how you really feel in a situation. Once you can name what’s going on it your body, you can then name your emotion. Once you have your emotion, you can start to make sense of it and decide what to do with it. That’s where your reason comes in. The magic is in the integration.1,7
This is tough work that you don’t have to do alone. A Counsellor can help you to figure out how to integrate your emotion and rational mind in a way that makes sense for you. It’s also a great idea to get into the practice of regularly scanning your body for sensations. This makes it easier to know what you’re feeling at moments where it really counts.1,9
Just as Mister Rogers said,
“Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone.”
When we begin to attend to our emotional sensations, we can start to name them. When we can name them, we can learn to manage them and integrate them into our decision making to help us live a balanced life.
To get started, check out some free online guided body scans can be found here:
https://self-compassion.org/category/exercises/#guided-meditations
https://www.livingwell.org.au/mindfulness-exercises-3/6-body-scan/
If you’d like some help moving forward with integrating your emotions, contact us and give us a call. We’d be happy to sit down with you.
References
Greenberg, L.S. (2015). Emotion-Focused Therapy: Coaching Clients to Work Through Their Feelings. American Psychological Association: Washington DC.
Siegel, D. J., & Bryson, T. P.(2011). The whole-brain child: 12 revolutionary strategies to nurture your child’s developing mind. New York: Random House.
Linehan, M. (2018). DBT Skills. Retrieved from https://app.psychwire.com/courses/c2629l/course
Living Well (2018). Body Scan. https://www.livingwell.org.au/mindfulness-exercises-3/6-body-scan/
Neff, K. (2018). Self-Compassion. https://self-compassion.org/
Rogers, F., & Neville, M. (2018). Won’t You Be My Neighbor? Tremolo Productions:
Thiruchselvan, R., Hajcak, G., & Gross, J.J (2012). Looking inward: Shifting attention within working memory representations alters emotional responses. Psychological Science, 23(12). https://doi.org/10.1177/0956797612449838
Yip, J.A., & Cote, S. (2013). The emotionally intelligent decision maker: Emotion-understanding ability reduces the effect of incidental anxiety on risk-taking. Psychological Science, 24(1). https://doi.org/10.1177/0956797612450031
Goleman, D. (2017). How emotionally self-aware are you? Mindful, 36. Retrieved from https://www.mindful.org/emotionally-self-aware/
What can I do about the “Baby Blues”
Understanding the Baby Blues
The transition into parenthood can be a time full of tender and beautiful moments, and it can also be a time of immense difficulty. On social media, we see a lot of those beautiful moments, but we don’t typically see the difficult ones. Many parents are then caught off guard and may even feel isolated and ashamed for the difficulties and alterations in their own mental health that can come with childbirth. While conversations about the beauty are important, it’s also crucial to talk about the difficulties.
About 85% of mothers experience the Baby Blues, which is a period after giving birth where mothers and some fathers experience profound sadness and anxiety. Baby Blues typically lasts 2 weeks to one month as women’s hormone levels slowly return to their base line. These perinatal hormonal imbalances can often affect a woman’s ability to respond to stress for a variety of biological reasons. On top of the physiological changes, there’s also an unimaginable number of new stressors that new parents may have never dealt with before.
Imagine if you were a lawyer for several decades, you were great at your job and thought of yourself as competent. All of a sudden, you were then thrown into a job as a chef at a high-level restaurant and everyone immediately expected you to know exactly what you were doing and to perform perfectly and instinctually. You may have read some books on cooking, but you find the high paced kitchen overwhelming and can’t always remember what you read when stressful situations arise, yet you feel ashamed for not immediately knowing how to adjust to this completely new career. That seems like a pretty unreasonable expectation for others to put on you and for you to put on yourself. Presumably, you would need a period of someone showing you how to do the job, you’d need support from your partner and friends with the stress of taking on a new career and you’d need time to eventually allow your own personality and creativity to catch up with the learning curve.
It’s not difficult to understand the time of transition in a drastic career change, and yet, we as a society assume that for most parents; especially women, parenthood and bonding with a new baby just comes naturally and easily. In reality, new parents are often overwhelmed by the anxiety of not knowing what their baby needs at first and they need time to learn. Breast feeding may be incredibly difficult, and your baby might never take to it. Contrary to popular opinion on social media, that is okay! Fed is best, any way you can make that happen makes you a superhero whether it’s breast feeding or formula.
During this transition, relationships may also become strained. Partners often need to re-establish new roles now as co-parents which can take time and can be challenging at first. Some co-parents may find themselves pulling away from each other due to the stress of not sleeping, having less alone time and trying to figure out this new role. This relationship strain can be a particularly harmful consequence because new parents really need support, especially during the period of baby blues.
How can counselling help the Baby Blues?
Relationship counselling can be really helpful during the perinatal period. During pregnancy, new parents can prepare for their shifting roles in counselling and determine how to best support each other when their new family member comes along. It can also be helpful to seek/continue relationship counselling after the baby is born for the same reasons.
Similarly, mothers and fathers can also benefit from individual counselling. They can learn to draw on their personal strengths to develop improved coping methods and gain better understanding of how to manage their unique feelings of stress. These skills derived in counselling can help new parents to best support themselves, their partners and their new baby as they embark on this new life transition that is both wonderful and stressful.
It is important to remember the phrase “it takes a village to raise a child.” You don’t have to do all of this on your own and there is so much strength in reaching for help.
This post has been about the Baby Blues, which is different from postpartum depression in terms of length and severity. My next post will address postpartum depression, what to look for and how to find help.
What is Postpartum Depression and What can Help?
Over the past two decades, we have seen a steady rise in media attention covering postpartum depression (PPD). This is partly because the psychiatric community officially recognized PPD as a distinct condition in the mid-90s and partly because of celebrities who have started to talk about their experiences with condition. And yes, you read that correctly, although there are abundant records of women talking about their experiences with maternal mental illness from the early 1800s to the present, we just started to recognize it as a distinct mental illness in the 1990s. As you might imagine, the result is that the science, the literature and the media reporting are all a bit behind. Luckily, with organizations such as Postpartum Support International (PSI), the science is finally starting to catch up and hopefully that means the media and our social perceptions of maternal mental health will too.
So, what is postpartum depression?
It’s often used as an umbrella term for all maternal mental health conditions, but in reality, there are several maternal mental health conditions that are distinct and vary in terms of severity, duration and characterization. All of these conditions tend to get jumbled up together in the media which is confusing for those who have PPD and their loved ones. So, let’s break it down.
The technical term for postpartum depression is a Major Depressive Episode with Peripartum Onset. What that mouthful of jargon basically means is that PPD can be understood as a depressive episode that lasts a minimum of 2 weeks and is characterized by depressed mood, insomnia or hypersomnia, fatigue, feeling worthless, low interest in pleasurable activities and having thoughts of suicide. If you read my last blog post about the Baby Blues, you might note here that PPD is very different from the Baby Blues which is a normal part of giving birth where most mothers experience a drop in mood right after giving birth. PPD not only last longer but is more severe. About 15% of new mothers experience PPD as opposed to 85% of mothers who get the Baby Blues. And while this distinction is important, keep in mind that whether you have the Baby Blues or PPD, you can absolutely get treatment, you don’t have to wait and see if it’s severe enough. Every person’s experience is different, and you deserve help. Do yourself a favour and check in with your Doctor, midwife and/or therapist to see how they can support you to feel like yourself again.
Men experience PPD too. A growing body of research has shown that roughly 5% of new fathers experience PPD which comes as no surprise because mothers and fathers both endure the many new stressors like lack of sleep, way more responsibilities and demands put of their plate, and feelings of failure and inadequacy often associated with bringing a baby home.
I won’t go too far into the causes of PPD here but if you ever want to talk about them, my door at Alongside You is always open.
I’ve spoken with a lot of mothers and fathers who were very confused about the way their PPD presented itself. Interestingly, PPD might look different from what we might think of as a typical episode of depression. A lot of people with PPD have reported either anger or anxiety as their primary symptoms. Some experience periods of elevated energy and racing thoughts where they’re unable to sleep and can’t stop cleaning erratically. Many also report panic attacks. While these responses may feel scary at the time, they are normal and can be helped with a number of different therapies that I will get into at the end of this article.
Overcoming Stigma and Getting Help
Experts agree that PPD is underdiagnosed, primarily because those who endure it often feel too ashamed to seek help. There’s a common misconception that PPD is associated with infanticide which is simply not true. Those over-reported cases of infanticide are not cases of PPD, they are cases of severe psychosis with peripartum onset. Unlike depression, psychosis is characterized by delusions and hallucinations. And even if a parent does show signs of psychosis with peripartum onset, it is incredibly rare that these delusions will lead to infanticide. I can’t stress enough how rare that is.
New parents are often under a lot of stress, and experience intrusive thoughts. When a person’s brain is in an anxious state, it’s common for their mind to go to the worst possible thing they could do (as if you weren’t stressed enough already…). This happens to all of us. Sometimes when I’m driving up the Sea to Sky highway, my brain imagines veering my car off the cliff. Of course, I will never do that, but my brain plays some pretty wild tricks sometimes, just like yours might when you’re under a lot of stress and your baby is still crying.
The main danger with PPD is that the stigmas that result from those sensationalized media stories keep many new parents from reaching out for help. As a result, suicide (not infanticide) is the greatest risk associated with PPD.
What can Help Postpartum Depression
As I mentioned at the start of this blog, science is catching up and we now have many treatments to choose from for PPD. Some find antidepressants helpful, like one woman said: “the me I was used to re-appeared after medication.” Other treatments include infant sleep interventions, massage therapy and relaxation, increasing Omega-3 intake (fish, nuts, seeds, healthy oils), spiritual practices, yoga, bright light therapy and, of course counselling (individual and couples counselling are both helpful). For most new parents, a combination of any of these above methods works best.
I’ll leave you with a simple and accurate quote from a mother I recently spoke with who had PPD: “Let people help, they want to.”
Some books that have been helpful to others;
Motherhood May Cause Drowsiness: Mom Stories from the Trenches: A Second Edition Monkey Star Press Anthology (What Is a Mother to Do? Adventures in Motherhood and Mayhem) - by: Lisa Nolan, et al.
When Postpartum Packs a Punch: Fighting Back and Finding Joy – by: Kristina Cowan
Tokens of Affection: Reclaiming Your Marriage After Postpartum Depression 1st Edition -by: Karen Kleiman, Amy Wenzel
The Birth Partner: Everything you Need to Know to Help a Woman through Childbirth – by: Penny Simkin
What is Social Anxiety?
Social Anxiety is an intense fear about one or more social situations. It can be generalized to all social situations, or it can be activated in specific situations, such as having a conversation, meeting new people, being observed (eating, drinking, walking, etc.) or performing in front of others (giving a speech, speaking in front of a class, etc.). According to socialanxiety.org, it’s the third largest mental healthcare condition in the world today. So, if you’re dealing with social anxiety, it might feel like you’re alone, but statistics show that you’re not, at least 7% of the population is right there with you.
Dr. David Moscovitch (a clinical psychologist at the University of Waterloo) discovered that social anxiety is more than just a fear of being embarrassed. Rather, it’s an urge to cover up a perceived flaw. People with social anxiety believe that something is fatally wrong with them that makes them socially undesirable, so they fear that this perceived flaw will become obvious to everyone and that they’ll be humiliated and rejected. For example, Joe may believe he’s really boring and that if people found out how boring he is, they wouldn’t like him. One day, Joe was talking to Martin and there was a long pause in the conversation which Joe perceived as an awkward silence. Joe believed the awkward silence confirmed that he was boring and that the awkward silence was therefore his fault. His brain became flooded with thoughts about how Martin must be noticing and judging Joe as a boring person who he doesn’t want to be friends with. Now, Joe’s mind is filled with even more anxiety so he can’t think about something to say to Martin. It’s so overwhelming he can’t bare the idea of being placed in this situation again where he might be judged as boring, so he proceeds to avoid social interactions as much as possible. In reality, Martin didn’t think Joe was boring, and he wasn’t judging him, he was lost in his own train of thought and didn’t think much of the “awkward” silence at all.
This is why Dr. Moscovitch stresses that this Joe’s fatal flaw on exists in Joe’s mind. He perceives himself to be boring and so finds information in the conversation to confirm that his perception is true. People with social anxiety are hyper-sensitive to social blunders to the point where they often believe they’re the only ones who make them. The truth is that social blunders are part of what makes us human. Everyone is boring sometimes, we all trip over our words and we all have awkward moments. As Dr. Ellen Hendrickson states in her book How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety, “nothing is wrong with you, it’s just the blemishes of being a person.”
It’s normal for everyone to feel socially self-conscious from time to time, but as Dr. Hendrickson says, “social anxiety is like self-consciousness on steroids,” it’s big, heavy and very hard to get around, so people who have social anxiety are often very distressed and unable to fully function in their lives. When self-consciousness reaches this level of strength, people typically need help regulating it.
Social anxiety works in a cycle of fear and avoidance. People begin to avoid the social interactions that make them feel anxious because the anxiety they feel is so painful and unbearable. They understandably want to protect themselves from the trauma of feeling rejected or inadequate. Unfortunately, avoiding social situations only makes things worse because when we’re not interacting with our source of fear, it builds in strength in our heads and becomes much scarier. On top of that, when we avoid certain social situations we’re also unable to practice the important social skills necessary to get through those situations. When we feel we don’t have the necessary skills for something, we continue to avoid it. And the cycle of fear and avoidance continues.
Desirable Traits that come with Social Anxiety
Many people with social anxiety believe there’s something wrong with them and want to change their personality all together. They often believe that the opposite of social anxiety is confidence. In her book, Dr. Ellen Hendrickson points out that people with social anxiety tend to have a lot of desirable traits. They’re so anxious because they desperately want to connect and belong, and so are sensitive to the needs of others to such an extreme that it becomes a fault. In fact, psychopathy; not confidence, is the opposite of social anxiety.
People with social anxiety tend to be very conscientious, compassionate and caring, open to new experiences and agreeable. They have all the traits that would make a person socially desirable, they merely are inhibited by fear and an excess of shame. It’s therefore best to work through social anxiety by removing the fear and developing confidence on top of the amazing characteristics that are already there! It’s a process of learning to be yourself without fear. Dr. Hendrickson points out that yourself is the self you are without fear. Think about the person you are when you’re most comfortable, maybe when you’re with a pet or with a person you trust or doing an activity you enjoy, that’s who you are and that person is lovable and worthy of connection.
How to Move Past Fear and Shame and Live the Life you Want
My next blog post will detail eight strategies for working through social anxiety. In the mean time, I recommend picking up Dr. Ellen Hendrickson’s book How To Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety. It is also a great idea to talk to a counsellor and see how you can work together to come up with a plan to work towards quieting that inner critic.
8 Strategies to help with Social Anxiety
In my previous blog post, I talked a bit about what social anxiety is and the many strengths that people prone to social anxiety often show. I recommend reading that post first, but as a little re-cap, people who develop social anxiety are often highly compassionate, conscientious and creative. They tend to feel deeply which can either lead to anxiety or an ability to creatively explore their world with curiosity. What stands in the way of the latter is an intense fear that they are not good enough. The following details some strategies to move past that fear while maintaining the many strengths.
1. Get out of your own head and turn your attention outward
When we feel socially anxious, we tend to turn inward and start monitoring ourselves. Thoughts like “why did I just say that” or “what if I just offended her” circle around and around in our heads and take up all our mental energy so we often then freeze and can’t think of anything to say.
When you notice this happening, turn your attention outward. Focus on who you’re talking to and listen closely to what they’re saying. This takes our focus away from what we think we’ve done wrong and frees up our mental capacity to be able to engage in the conversation with natural curiosity. Studies show that doing this dramatically increases a person’s likability.
2. Expose yourself to social situations and allow confidence to catch up with you
Don’t wait until you feel ready to give that toast or attend that party, usually when we start doing something, our mood follows. You’re more adaptable than you think. If it doesn’t go well the first time, keep practicing, if you persevere, the skill and confidence will catch up with you.
This allows you to refute the two lies your anxiety tells you:
1. The worst-case scenario will definitely happen
2. You can’t handle what life throws at you
When we face social fears we learn that we can live through it and it’s never as bad as we think.
tip: sign up for an introductory improv class. In improv there is no script and you’re put in a situation where you’re forced to make mistakes in front of others. Sounds terrifying right? I thought so too so I tried it at the height of my social anxiety and it ended up being surprisingly safe. At first it was embarrassing but then I realized everyone was being embarrassed. Improv helps us to develop the skills to navigate unstructured social situations that cause anxiety in the real world.
3. If you drink at a social engagement, do it because you want to, not because you have to
A lot of people drink to make themselves feel more confident in social engagements, after all, it is called “liquid courage.” The problem is that if you do have a good time while drinking, the tendency is to give the alcohol the credit, not you. In reality, that person who was having a good time navigating an otherwise anxiety-provoking situation was you without inhibition. You have that confidence within yourself and you can access it with practice facing you fears, you don’t need the alcohol.
4. Dare to Be Average (Dr. David Burns)
A lot of anxiety comes from our belief that we need to be perfect in social situations. We believe that if we stumble over our words or pause in a conversation, people will see our flaws and reject us. There’s a whole list of “musts” that come with that belief:
-“I must be entertaining”
-“I must sound smart”
-“I must carry the conversation for both of us”
Everyone pauses in conversations, loses their train of thought and says something awkward from time to time, it makes us human and it’s endearing. Dr. David Burns encourages us to “dare to be average” (https://news.google.com/newspapers?nid=1915&dat=19811027&id=CnYfAAAAIBAJ&sjid=XXUFAAAAIBAJ&pg=1877,6264365&hl=en). He reminds us that people are attracted to people who own their averageness because most of us are average. It’s relatable, it’s honest and it’s human. As Dr. Kristen Neff says, “we’re all on this long, awkward journey together,” if you’ve experienced an embarrassing moment, a million other people have had that same embarrassing moment, you’re not alone.
5. Create structure for yourself in social engagements
Simon Thompson and Ronald M. Rapee (2002) found that in structured social interactions, people with social anxiety showed a much higher level of social skill than in unstructured social engagements. Dealing with the unpredictable creates anxiety for many people so next time you’re in an anxiety-provoking social setting, create structure for yourself. Dr. Hendricks suggests giving yourself little missions at parties such as taking to 3 people you don’t know and finding out as much as you can about them. This creates some predictability and some direction in the social interaction.
6. Dr. Hendrickson’s Tips for Making New friendships
A) Repetition – Show up!
It takes an average of 6 hangouts for someone to consider a person a friend. Many people with social anxiety become discouraged when they work up the courage to go to a social engagement and don’t come away with a new friend. But in reality, this almost never happens for anyone. The way to make new friends is to keep showing up and to see the same people over and over again. Some options might be joining a fitness class with consistent members, dropping the kids off at school and saying hello to the same parents each day or going to a café at the same time each day.
B) Self-disclosure
Many people with social anxiety have trouble talking about themselves for a variety of reasons that may feel really valid after past hurts. Dr. Hendrickson urges us to push through and to gradually share a bit about what you think, feel and do with a person you want to be friends with. Friendships are reciprocal, so gradually the other person will begin to share about themselves as well. People are generally interested in what the world looks like from another’s point of view.
C) Just be kind
Many people think they need to appear confident and competent in order to make friends. In reality, people are drawn to warmth, kindness and trustworthiness. You don’t have to appear confident, just be nice and curious.
7. Practice self-compassion
Shame feeds social anxiety, but if you can think about yourself in the same way you’d think about another person you care about, it will help you to forgive yourself when you make a social blunder that feels so painful and isolating. Dr. Kristen Neff has an amazing website full of exercises to help build self-compassion https://self-compassion.org/category/exercises/#exercises. My favourite is the self-compassion break which is a guided mindfulness exercise that takes only 5 minutes.
8. Counsellng
Social anxiety can be completely unbearable and painful and so it can be hard take any of the above steps on your own. A counsellor can help work with you, at a pace that feels safe for you, to remove the blocks of shame and fear that are inhibiting you from living the life you want to live.