EMDR with the Perinatal Population
As a mental health therapist in the Fishers, Indiana area, I enjoy all of my clients (even the ones that challenge and stretch me out of my therapeutic comfort zone.) But there are a few types of clients that I especially love working with. One is new or aspiring moms (I call it “maternal mental health”— encompassing the pre-conception, pregnancy and postpartum periods). The other is trauma survivors (I especially love using EMDR to treat trauma; it’s so rewarding to have a front-row seat to watching the brain heal).
There have been a few times that these two speciality areas have overlapped and I’ve had the privilege of working with moms who have experienced trauma or significant distress during pregnancy or the first year after giving birth.
Today I want to outline a few of the ways I’ve used EMDR to support these moms.
Miscarriages
Experiencing a miscarriage (or any pregnancy or infant loss) is obviously extremely traumatic and distressing. Adding to the grief is that, especially when miscarriages occur early in the pregnancy when the couple may not have shared the pregnancy with many people, the loss can seem hidden or moms may feel invalidated in the depth of their emotions. Miscarriages represent not just the loss of the baby, but also loss of the dreams that start to unfold as soon as (or even before!) the pregnancy is discovered, and often also spark fear for future pregnancies (“Will I have another miscarriage?”). Many moms feel isolated after miscarriages because their support people seem to “move on” and forget about the loss. Compounding this sense of loneliness is that each partner grieves the loss differently, and often moms feel they have to hold in their grief because their partner doesn’t seem as upset or “gets over it” faster.
EMDR could be used any time after such a loss, from immediately following the miscarriage to decades later. The specific times that I have used EMDR to target miscarriage-related memories happen to have been a few years following the miscarriage. We start by focusing on what emotions or body sensations are happening in the present (often separation anxiety from the baby/toddler, or fear of becoming pregnant again and having another loss). Some moms report beliefs of “It’s my fault,” “I did something wrong,” or “I’m alone.” We then float back to target the memory of the miscarriage, which often involves traumatic images of the miscarriage and body sensations such as nausea or tension.
After reprocessing, of course moms still feel grief about their loss. However, many moms report feeling a sense of relief, especially from guilt. New beliefs emerge, such as “I did my best, I was the best mom I could have been, and I am strong.” Future templates can also be applied if the couple plans to keep trying for future pregnancies, having the mom envision different stages such as trying to conceive, becoming pregnant, and even the possibility of enduring another miscarriage, carrying these new beliefs of “I can do my best and I am strong.” This helps moms feel empowered to step into the future with confidence— even though they can’t predict what will happen next, they can approach life with courage and strength.
Birth Trauma
One of the first mantras that is taught in perinatal mental health trainings is “Trauma is in the eye of the beholder.” In other words, no one can tell you whether or not your birth experience was traumatic— if it seemed traumatic to you, it was traumatic. Sometimes moms minimize their experiences because they don’t feel right about comparing themselves with others who seem to have had it “worse.” They might think, “I ended up with a healthy baby, so I should be grateful and shouldn’t call that experience ‘traumatic.’” I’ve heard many people say, “Trauma is what happens to soldiers in a war, or people who are raped. What happened to me wasn’t to that extreme, so it’s not trauma.”
It’s for this reason that I talk to clients about EMDR being helpful for memories that are “traumatic OR distressing.” If you are distressed by things that happened to you in the past, it doesn’t really matter how you label it, but you deserve the opportunity to feel better.
I’ve seen EMDR successfully reduce flashbacks and anxiety related to long labor, difficult pregnancies such as enduring hyperemesis or bedrest, and lots of other complications that felt out of control and make it difficult to move forward.
NICU
Having a NICU baby is often very unexpected and traumatic. You finally get through labor and delivery, only to be abruptly separated from the baby who has been joined to you for many months. While mom is recovering physically from labor and can’t leave the room to go to the NICU right away, her partner feels torn about whether to stay with her or follow the baby. Add sleep deprivation, shock, hormones, and fear of whether the baby will be okay to this scenario, and you have a real recipe for PTSD. If the baby is in the NICU for more than a few days, parents may also have to face the decision of whether to stay at the hospital full time, or travel back and forth to sleep at home each night. Parents may also need to return to work, having to place their trust in hospital staff to care for their fragile infant.
EMDR is often helpful after this situation. Targeting images (for example, the mental image of their baby looking fragile with tubes and monitors everywhere), beliefs (“I’m helpless, It’s my fault, I’m abandoning him”), emotions (guilt, helplessness, fear), or body sensations (often tension in the chest or shoulders) are all appropriate starting points for reprocessing.
After reprocessing, many moms are able to put this difficult situation “in the past” and be freed up to move forward into the future. New beliefs of “I did everything I could; it’s not my fault” start to feel stronger and allow them to feel less anxious about their baby’s health and more confident in parenting.
Sexual Trauma Prior to Pregnancy
For women who have experienced past sexual trauma, the journey into motherhood may feel especially perilous. Even for women who have done a lot of work to recover from this experience may find that the season of conceiving, pregnancy, delivery, and learning to care for a newborn can bring up new insecurities, flashbacks, and triggers. So much of this season of life feels out of control— which is sometimes a similar feeling to being victimized in the past.
EMDR can be helpful to target past abuse, focusing on the current anxiety and floating back to the past memories that feel similar in the body or hold similar beliefs about oneself.
While EMDR during pregnancy isn’t necessarily contraindicated, the therapist, medical doctor, and client should be mindful that EMDR does bring up strong feelings in a controlled environment of the EMDR session. This anxiety can impact the baby. The EMDR therapist is trained to help the client stay within the window of tolerance during the session and end the session with containing or calming techniques to keep the client grounded throughout the week. However, it’s important to weigh the fact that any anxiety, especially through severe flashbacks or other forms of intense anxiety, will also be daily impacting the baby. A decision should be made about which risk is lowest to both mom and baby.
Adoption
I have also used EMDR in several different types of adoption scenarios. First, in working with moms who were adopted. Moving into the life phase of becoming a mother herself often brings up feelings of confusion and rejection “I love my baby so much; how could my mom have placed me for adoption?” There are often increased feelings of insecurity and anxiety. EMDR can be helpful to help moms reprocess these emotions of feeling unwanted and help them feel more settled about their own identity as a person and as a mom.
I have also used EMDR with adoptive moms who struggled with the disappointment of not being able to conceive, or feeling equipped to handle behaviors of their adopted kids.
As an EMDR therapist in Fishers, I have found using EMDR with clients to be one of my most rewarding experiences. In joining clients in their areas of pain, and using an evidenced-based treatment to actually change how the brain stores life experiences, I’m honored to be a witness to their healing.
If you’re ready to “put the past in the past,” contact me to schedule an intake appointment and find out if EMDR could benefit you.