Perception and Trauma Recovery

Both the event and the perception of the event must be considered when discussing trauma – Jane Simington.

I want to preface by noting that what I am unpacking in this post is not new information. There are plenty of people who have been writing about some of the concepts below. However, every time someone attempts to write about, what I believe to be are spiritual ideas of transformation, I like to imagine that it means we are getting closer to a collective awakening. Therefore, please know that I am not claiming to be an expert on this topic, but instead, I write about perception, trauma, and consciousness through lived experience and many nights of contemplation.

……….

Over the years I have attended numerous pieces of training on trauma recovery, along with an incessant drive to consume information about the topic. In the beginning, I was driven to understand my diagnosis of PTSD and to unearth how I can heal. This drive never ended and resulted in me finishing grad school, training as a trauma-informed therapist, and developing a healing program for mothers.

I think what inspires me the most about becoming trauma-informed is the power gained. I knew in my bones that I could heal. And I hold this belief for others as well.

In my past, I struggled with depression for years, and I felt disempowered and afraid of being diagnosed with a mental illness. I held a perception that it meant that I would be cursed forever.

I tried to change my thoughts so I could feel better. However, I didn’t experience the results I craved. Granted, this quest to ‘change my thinking’ helped me become mindfully attuned to my thoughts. And as it stands, mindfulness is now receiving gold star status in healing and recovery.

Our physiology is innately intelligent and has a seeking drive that ‘seeks’ to attune towards health. I love this about our bodies. And our mind is deeply interconnected to our physiology (for those eager to unpack the concept of the mind, read The Mind by Dan Siegel).

The body and mind are one.

It is about time that we claim this knowing. Therefore it makes sense that both the physiological impact of an event AND the psychological impact of the event ought to be a part of the trauma discourse.

There is plenty written about the physiological impact of a traumatic event. To name a few, in ‘The Body Keeps the Score’ and ‘Waking the Tiger,’ both Van der Kolk and Levine, discuss the physiological imprint of trauma. Dan Siegel, founder of Interpersonal Neurobiology and author of a handful books, writes about healing from the mind, body, and relational perspective.

The literature readily available today surmounts what was available just six years ago. It is as if trauma-informed care has skyrocketed. I imagine it has done so because it speaks to how we can heal tangibly. It offers a perspective on causation to many of today’s mental, emotional, physical, relational, and behavioral challenges –not just a list of symptoms but a probable physiological cause due to unprocessed traumatic material in the nervous system.

Within the conversation of trauma-informed care, we recognize that each is impacted by a traumatic event differently; each has different variables to consider. One of the variables concerns how the experience becomes etched into the mind/memory/psyche of the individual; in other words how the individual perceives the event.

 

This comment has left me with many questions. A somewhat simple statement is full of complicated calculations and considerations.

What is perception?
How is perception formed?
How do we control perception? Or do we? How do we change perception?
Who is in control – self or brain?
Who is self?

As you can imagine this spiraled me down a rabbit hole of deeper discovery, philosophical consideration, spiritual questioning, and scientific evidence. Unpacking the notion of perception is not an easy task. There is little room for error because misrepresenting a concept could send the reader down the wrong rabbit hole.

And yet, isn’t it all perception anyway? Meaning the lens through which you read this has perceptual embedded within it, filters.
This leaves one to pose the following question: what are those filters made of?

Definition of Perception

Perception, according to the Dictionary refers to “the ability to see, hear, or become aware of something through the senses. The neurophysiological processes, including
memory, by which an organism becomes aware of and interprets external stimuli. 2 the way in which something is regarded, understood or interpreted. An intuitive understanding and insight.”

Thus, perception is the process in which we make sense out of an event. It includes our thoughts and senses. Perception informs how we communicate about an experience, both externally and internally. In other words, we are meaning-making machines.

For some time now, I would argue that we were taught that we have free will and thus, how we understand and interpret an experience is within our realm of control. And so, if it is within our power to influence how we perceive an experience, then do we have control over how we make sense out of an event? Regardless if the event is positive or traumatic.

This above notion may sound optimistic and perhaps even motivating for some. And when I first considered this idea I felt empowered to do something about my state of being. That said, the deeper I went down the rabbit hole, the more challenged I became by this concept.

Unpacking Perception

First of all, I felt frustrated that I encoded my traumatic events in a negative light that complicated my healing and my physiological response to trauma. I experienced self-blame. Why is it that some people could move on and have a less aggravating perception of an event, while others become entirely derailed by the experience? Could perception be the main differential factor?

Let me offer an example specific to the demographic I mostly serve:

Mother 1 – comes to therapy because she had an unplanned, unwanted c-section after a transfer to the hospital that resulted in complications that could have been terminal for either herself or her newborn. She is relatively calm about the event, is processing some grief due to the loss of physical constitution and dream birth, but she has a healthy perspective the c- section was the best option at the time and that It makes sense to her. She feels sad about the event but grateful to be a mother. She expresses frustration that she didn’t plan for a c-section or a complication arising and felt annoyed with herself (a bit foolish) but otherwise, she ‘get’s it.’ It was needed. I am well. My baby is well. We will be okay. After a few sessions of grief therapy, this mother feels like she has made sense out of the experience and in her words: ‘I am okay with what happened.’ She isn’t showing any signs of dysregulated physiology, and one would assess that she is not carrying any trauma about this event, even though her life and her baby’s life had been threatened.

Her perception = I am okay. My baby is okay. It is over now. We are okay. It makes sense to me. It is okay to have disappointment and grief, and I will move on.

Mother 2 – Comes to therapy because of an unplanned, unwanted c-section after a transfer to the hospital and being told ‘failure to progress’ and ‘your baby’s heart rate is dropping.’ Everything about the event feels horrifying to her. The image I get is that of a battleground. She felt the terror that her baby was unsafe. She didn’t want to cut open. She didn’t trust the hospital staff, and she didn’t trust the midwives. She presents as dysregulated, hyperaroused, disorientated, and has big energy and emotions. The sense you get is as if she is about to

explode or float out of the room. She has difficulty maintaining eye contact. She wants to tell you her story over and over again. One of the themes is that the caregivers failed her and she finds fault in all that they did. Everything was a violation of ‘abandonment’ to ‘touching without her consent.’ In a nutshell, she has perceived the event as violating, disempowering, disrespectful, disheartening, and believes that the caregivers are to blame.

Her perception = I was harmed. I was violated. I was mistreated. It is all their fault. I was neglected.

Granted these are radically different examples, but they are based on similar cases. Both Mothers experienced unwanted c-sections, transfers to the hospital, and a threat to their baby’s wellbeing. Both suffered physical trauma due to surgery (according to Levine, surgery is a trauma) and each would have experienced prolonged pain due to an induction at some point throughout their labor. Further, childbirth is an incredibly vulnerable experience. Therefore some of our protective strategies that keep us feeling a sense of control in our lives are dropped during labor and birth. Both mothers were equally at risk of having experienced their birth as traumatic based on these factors alone.

However, both had different experiences and are processing differently in the postpartum. Recovery has been quicker for Mother 1. Mother 2 presented with symptoms of postpartum PTSD. All of which poses the question, why did Mother 2 imprint her birth as traumatic? Did she have control over this? Does she have the power to change her perception of the event? These are hard questions to consider. By no means does it reflect that Mother 1 is ‘behaving’ better than Mother 2.

The trap that the old worldview can feed – Just get over it and get on with it, it is selfish to focus on the self.

This worldview leaves mothers feeling ashamed and guilty for how they are responding to their childbirth and can result in suppression of emotions and thoughts. The old ‘ignore it and it will go away’ mindset. I don’t think I need to explain to you that this does not work because your physiology won’t forget about it. As Van Der Kolk states: ‘Your body keeps the score’.

Unfortunately, there is no ignoring; there is only going through.

There are so many variables that could have contributed to each of the Mothers experiences of birth. I am sure I will miss a bunch, however, here is a list of some distinct factors to consider:

  • History of attachment with family of origin
  • Adverse childhood experiences – abuse/neglect/poverty/malnutrition
  • History of oppression – marginalized race, gender, religion
  • Financial circumstances
  • History of sexual assault
  • Nutrition
  • Support systems
  • Religious or spiritual beliefs
  • Physical health before birth
  • Mental health before birth
  • Marital status and relationship health
  • Other stressorsAll of these reasons and more influence a person’s ‘way of being’ in the world. Further, they inform how our physiology and psychology encodes (make sense of) life events. Unless we become conscious of this material intrinsically, we cannot ‘change’ our way of thinking and being.

    Therefore, can we control how we perceive an event at the time of the event? Or is it only afterward that we can influence how we store the information?

    From what I understand, our past informs our present way of being until we wake up to the programs of the past. Therefore, if we are unconscious of how our past experiences have influenced our way of thinking, feeling, doing, and being, then we have no power to change our perception of an event.

    Perception is how we make sense out of a life event. And how we make sense out of current circumstances is based on our past experiences. Therefore, we are living in the past until we become conscious of these core patterned ways of being. Dr. Joe Dispenza speaks powerfully about this notion in his book ‘Breaking the Habit of Being Yourself.’

    We cannot escape life without experiencing traumatic events. Granted, some more horrific than others. However, from what I can see and read, humans have been suffering from trauma as far back as we can go.

    We have a physiological system that responds to trauma and fights for our survival. The problem is that once we have ‘survived,’ unlike other mammals, humans have a hard time returning to a state of calm, connected homeostasis. The challenge is that our neocortex gets in the way.

    We have a thinking brain that tries to make sense out of the sometimes senseless acts and experiences. This brain is responsible for our evolution, and also, it keeps us trapped in trauma as we relive it in our mind’s eye over and over again. It is as if trauma glitches the system for some and puts the record on repeat. Thankfully, there are ways in which we can recover and respond to the glitch that puts the nervous system into overdrive.

    It is imperative that the trauma (i.e., stress) response completes its instinctive cycle. Thus, body-centered therapies are beneficial. They can move the trapped energy in the nervous system. Associated with this nervous system energy are all the thoughts, emotions, felt sensations, and images about the event. Those also need to be processed, and ‘digested’ so that the limbic system can turn off the alarm bells.

During this process, I am noticing that the final phase of recovery pertains to a change in perception in which the person views the situation from a different vantage point – usually, this involves a compassionate release towards self and other.

This does not mean that if someone experienced violence and violation that the perpetrator is not held accountable for their harmful actions or that a mother does not file a complaint against a caregiver if deemed necessary.

But instead, the perceptual field grows to include a deeper understanding of the self at that time, the others at that time, and any influencing historical information that would elicit a compassionate tone of understanding.

Sound like a spiritual awakening?

From my perspective that is exactly what is happening when we grow from one state of perception to one that includes the self, other, living creatures, planet, and cosmos. In a state of deep understanding, we by-pass our conditioned responses based on historical content. Our physiology may ‘keep the score,’ but one can argue that ‘consciousness’ exists within and without the physiology.

When we can ‘know’ that we are more than our physiology, more than the programs we have received through genetics and experiences, we can begin to change our embedded reactionary response to life events – be it traumatic or ecstatic.

For many, trauma is a wakeup call to move beyond the physiology. One’s physiology will be full of experiences and patterned responses to those and similar experiences. We cannot do anything about our past experiences, but we can change how we think and feel about them.

When faced with a traumatic event we may not be able to influence how our system responds to that experience; our physiology responds quicker than our thinking brain can. It is as if we are always one step behind the body’s imprinted and instinctive reactions. How can we catch up?

This leaves me to pose a question about consciousness itself or rather the part of the self that is the Witness, the spiritual self, the higher self, the One, the Void. Perhaps Buddha was on to something as a contemplative enlightened figure who speaks about the cycle of human suffering. He speaks about transcending suffering by non-attachment to the ego identity. I hear un-attachment to our physiology.

The physiology holds the imprinted ways of thinking, feeling, and doing.

When traced back all the way to the womb of the mother, we know that chemicals that tell us if we are safe, wanted, secure, loved are already being embedded into our growing embryo. We learn about the external world before we are born via our mother’s response to it…and on and on we go.

One could argue that we are born imprinted with pertinent information about our place in the world. From that area forward we learn about our physical self through relational attunement with our primary caregivers. Before we can make sense rationally, we are receiving perception about belonging, safety, love, pain, emotions, and behavior. We mirror those around us.

 

Our personality emerges from these experiences. I liken my personality to a large dose of environmental circumstances infused with the energetics of my ‘soul’ (another blog post on that notion). Much of how I perceive myself is based on external circumstances that informed me about myself. From here we see the birth of ‘core beliefs.’ In particular, core limiting beliefs.

Our perceptions are infused with core beliefs about the self, others, and ways of being in the world.

Thus, going back to the earlier example about the two different mothers. One could postulate that Mother 1 holds a core belief based on historical experiences – I am okay in the world, it is safe to be here. Whereas, it is possible that Mother 2 holds a core belief based on historical experiences – The world is unsafe, and I am at risk of being harmed.

I am making a broad stroke with this last statement. However, I am offering a point of view that how we currently perceive aspects of our history profoundly influence a traumatic experience that we have not considered before. Elements such as core beliefs based on childhood experiences. Secondly, I am suggesting that trauma is an opportunity for awakening to the ‘self’ that exists outside of our physiology. As such, perhaps from this place, we can rewire how we store memories so that we are no longer chasing our physiological reactions, but instead, changing the program so that the physiology responds differently in the future.

Is this not what the ancients meant when they said: When you heal, you heal seven generations back and seven generations forward.

 

Advertisements

Birth Shame & Blame: A Response to An Epidemic

midwiferyfor soul quote

For twelve solid years I pioneered the natural birth industry as a childbirth educator, doula, student of ‘traditional’ midwifery, and advocate.  This included a strong focus on instinctive and physiological labor and birth.  The motivation to teach about the power of birth, from this lens, was supported by scientific evidence in the fields of physiology, endocrinology, neuroscience, personal experience and a belief that the mammalian female body was created to give birth instinctively.

Deeper yet, I became a spokesperson for natural birth after the birth of my first child because I saw birth as a women’s rights issue; I wanted to stop violence against women in birth.  Naturally, I saw the medical institution as the culprit (and those who worked within it) and Midwifery as the solution.

I believe that all passion is motivated initially from a place of heart and soul; a desire to ‘do good’ and ‘help’.  However, although the initial motivation stemmed from a place to ‘do no harm’, it is hard to maintain that place of pure motivation without developing an ideology.

I want to talk about how the ‘natural’ birth ideology can be contributing to the concerning rise in childbirth shame and postpartum depression. Including my personal and professional mental battle, as I wrestle with this paradox and help mothers find healing.  

Fifteen years deep I am still grappling with the question: If birth is physiological and instinctive than why is it not the experience for so many labouring mothers?

What stands in the way of accessing this mammalian birth right?  And why does it matter?

For years I believed that if care givers would just support birth physiology and get out of the way with all of their protocols and interventions, then women would birth instinctively and uncomplicated most of the time.  This led to a belief that the reason why there is a high rate of complicated births, followed by unwanted c-sections and interventions, was/is the caregivers ‘fault’ for not applying physiological evidence based care.

From this vantage point the ‘cure’ was/is simple: Care givers need to change their practices to be supportive of physiological and instinctive birth.  

The First Layer of Blame

This mindset led towards what I would consider to be the first layer of blame: If childbirth did not turn out the way the mother had hoped, someone is to be blamed, and that someone is the caregiver!  

For a few years I was stuck in this mindset and could not see beyond it.  Care givers of birth (Obgyn, Midwives, Nurses) were at fault; the system was at fault; and the education was at fault.  Mothers could scapegoat their authentically painful feelings by adopting this mindset.  Instead of authentic grief being expressed in response to their unwanted birthing experience, mothers could project anger towards the institution of birth and make them ‘wrong’.

This anger has fuelled many movements within childbirth: Freebirth/unassisted birthing; Cesarean prevention and awareness; Mainstreaming midwifery; Childbirth rights; Thousands of blogs and videos; Documentaries about the politics in childbirth; and Lawsuits against mistreatment in labor.

These movements have opened up the conversation about childbirth in that, giving birth is no longer a private affair but a public topic of conversation.

Within a decade I have personally witnessed the business of birth BOOM! Doula is no longer a puzzling sounding word with no context; but rather a necessity for pregnant families to have by their side.  We have experienced an explosion within the Doula industry: There are more courses and instructors now, more Doulas, online programs, extra ‘workshops’, birth bag supplies to be purchased, and even postpartum doulas.

If you are pregnant you are bombarded with more than a handful of different childbirth classes to take, all of which are most often focused on helping you have a ‘natural’ childbirth experience; some even focusing on hypnotherapy to help you train your brain to ‘let go’ in labor so you can have a pain-free physiological labor.

Midwifery has become mainstream (for the most part) and more and more people are hearing the word and choosing a Midwife as their primary care giver.  And, for pregnant families within my home city of Edmonton, many are denied access to care because there are not enough midwives to serve the demand.  Met with outraged citizens, many of these women who are denied access of care are afraid to give birth with an Obgyn in attendance (I was one of these women who feared OB care).

The Second Layer of Blame

This feeds what I believe to be the second layer of blame: The system has denied women access to caregiver of choice; it is therefore the systems fault for a unwanted birth outcome.  

Again, outrage in regards to ‘lack of choice’ has motivated a movement to draw awareness to the fact that this lack of choice is a violation of birth rights.  This has led to what I would call the second wave of unassisted birthers.  The first wave was motivated by a desire to have autonomy and ownership over the birth experience, the second wave is in response to a denial of care.  Two different starting points.

In all of this, the natural birth movement is still very much at the forefront of all of these movements.  From what I have gathered over the years, more women are desiring a natural birth because of a belief that this is the best way to give birth.  A belief that I have fostered and fuelled.  And although part of me believes that this is true, I cannot know that it is the absolute truth – especially if it is causing much emotional pain amongst todays mothers.  Birth empowerment and informed choice are high up on the ‘needs’ list for pregnant women.

And throughout my career as an advocate and educator, I taught exactly this:  If you just get the right caregiver (or no caregiver), who supports birth physiology and altered states, and who listens to you and supports your needs, you will feel safe enough to let birth happen to you.  

All you need is the right environment that supports your hormonal needs in labor, and you need to be undisturbed and left alone so you can find your way.  Albeit, all of this was/is supported by science and what we know about instinctive physiological labor, I still found myself perplexed when I attended or was told about a ‘birth that didn’t work out’.

What went wrong? Who interrupted the labor? Who was to blame?

Underneath these initial responses were thoughts that something got in the way: It must have been due to hidden unprocessed trauma; discomfort with letting go; psychological challenges; unhappy relationship; discomfort with sexuality; discomfort with losing control; low pain tolerance; unsupportive environment etc.

As you can see, there are thousands of possibilities.  Some of which may be true; they may have contributed to the outcome.  However, what is the benefit in figuring it out and focusing on all the reasons why birth ‘didn’t happen’ the way a mother had hoped it would?  What if how a mother gave birth didn’t matter, as long as she was supported in a kind, considerate, humane way?

The Third Layer of Blame

This leads to a third layer of blame: I, the mother, must be at fault.  My body failed me because I didn’t have the outcome I wanted…the outcome that society is suggesting I have.  Anything ‘less’ is unforgivable and someone needs to be ‘blamed’.  

When there is blame there is shame.

Each of these three layers of blame foster shame and worse, distrust in the self (and body for future births) and the other (care givers).  This is cultivating the very thing that I, as an advocate of natural birth, was trying to eradicate from the very beginning: violence against women in childbirth. I can’t believe it has taken me this long to realize this and see through the cracks.

What is worse: overt externalized violence or internalized self-perpetuated violence?

Violence is violence and they both feed disempowerment and oppression.  Internalized shame is a violent act that disempowers every mother; diminishes her life force; keeps her from feeling joy in her children; feeds the belief that the female body is defective; and separates mothers from each other (natural birth camp versus medicalized birth camp).

We want to foster a society that empowers mothers and families

It is ironic and beautiful that my path has led me towards a counselling profession in which I help mothers heal from childbirth trauma.  I am honoured to hold the stories of shame and guilt, as I sit on the receiving end and see the damage that can be caused by a birth ideology: all women must give birth physiologically, naturally, and instinctively.  I am humbled as I sit in sessions and hold raw grief, grief that is behind the anger and the blame, grief that comes from relief and release from these binding mindsets.  Grief that happens when a mother realizes she doesn’t have to hold onto the blame.

Although I still believe in the science that supports birth physiology, I have stopped my need to blame: blame caregivers, lack of choice, or women.  Rather, as a holder of stories I recognize that it is far more than this.  It is about transcending this mindset and discovering a new mindset that fosters the most kindness towards self and other.

From this kind inner place true joy can flourish regardless of one’s birth experience.  

NOTE: I am not suggesting that we turn a blind eye and ignore overt abuse that does occur in childbirth.  This type of childbirth trauma needs addressing and consequences.  There is no room for violence period.  Also, I chose to use the words: she and women.  I acknowledge that not all pregnant people identify with these labels and that the language around birth is changing.  Please know my intention is to be inclusive to all peoples.