Sunday, March 26, 2017

How Ireland treats pregnant women

I’m writing this post because women’s rights are far from being in the bag and the abuse of women while pregnant, during birth and beyond is just disgraceful and far too common, the world over. This particular post is about how Ireland treats women while pregnant. It might not affect every woman, but if it affects even one, we should care enough to do something about it. Unfortunately too many women have been affected, so it’s really time to do something about it.

If the 8th amendment were repealed tomorrow, securing an abortion in Ireland would still be as difficult as it is now. The Protection of Life During Pregnancy Act 2013 would remain in force, untouched, regardless of what happens to the 8th. Many people seem to forget that, very conveniently in many cases. I believe it is a mistake to equate repealing the 8th amendment with abortion as abortion is such a contentious and emotive issue that divides people. And this may be exactly what the Irish state wants, so they can continue with their moral cowardice on the issue, hypocritically exporting the issue and women abroad, while keeping the fact that they hold the legal rights to the bodies of all pregnant women in Ireland, quiet. This is the case whether a woman wishes to continue with her pregnancy or not.

The 2013 Act is one of the strictest such laws in the world according to Eoin Daly, lecturer in constitutional law, NUIG. Therefore the fear that there will be abortion on demand if the 8th is repealed holds no weight whatsoever and is completely unfounded, because the 2013 Act would strictly prevent that. This fear is also an insult to the intelligence and sensitivity of women that if the 8th were repealed, they’d be having abortions right, left and centre.

What would happen if the 8th is repealed, is that the legal right to bodily autonomy would be restored to all pregnant women, which is not a step forward, it just brings us in line with most of the rest of the world and about time at that. The right to make our own medical decisions and informed consent and refusal would legally rest with the woman while pregnant. I don’t know how anyone could object to that. Do we honestly need to hold women legal prisoners of the Irish state while pregnant so they don’t ‘misbehave’?? Are we still in the dark ages in this country when it comes to women? It seems so.

Ireland took 30 steps backwards when article 40.3.3 (the 8th amendment) was added to the constitution in 1983. Of course this addition was reflective of the culture in Ireland towards women at the time which was just 30 years ago. Magdalene Laundries were still in existence, pregnant girls were still being thrown out of their homes with nowhere to go, pregnant teachers who were single were losing their jobs, pregnant teenagers were still hiding their pregnancies because of fear and shame. But this is 2017 and where are we now in Ireland? Have we changed in our attitudes to women?

No, we haven’t, at least collectively. In fact the Irish state has taken even more steps backwards in relation to women’s rights. In 2013, the 8th amendment was added to the national ‘consent’ guidelines for pregnant women by the HSE. The relevant section states that:

“Section 7.7.1 Refusal of treatment in pregnancy
The consent of a pregnant woman is required for all health and social care interventions. However, because of the constitutional provisions on the right to life of the “unborn”, there is significant legal uncertainty regarding the extent of a pregnant woman's right to refuse treatment in circumstances in which the refusal would put the life of a viable foetus at serious risk. In such circumstances, legal advice should be sought as to whether an application to the High Court is necessary”.

Why, after 30 years, were the consent guidelines amended? In my view, it was a financial move to limit liability. The obstetric bill is the biggest in the state claims agency. After bailing out the banks, there’s not much money left in the coffers. There are too many women coming forward, standing up for themselves, speaking up, taking cases, fighting for their rights and the Irish state doesn’t like it one bit. What better way to shut them up than by explicitly mentioning the 8th and the high courts in the consent guidelines, even if it’s ‘just’ to scare them into silence and obedience. Bullying is endemic in Irish society, particularly in our institutions and government.

In 2014, Ciara Hamilton was told by a judge that she was not the person entitled, authorised or qualified to make decisions about her own body while pregnant, her midwife was. Can you believe that? In 2013 and 2016, two women were brought to the high court by the HSE who sought orders for forced sedation and forced caesareans. I don’t know about you, but the possibility that this can happen in a so-called modern and progressive country sends shivers up my spine.

Miss Y was given a “termination” after being raped in her home country and sought an abortion at 8 weeks because she was suicidal. She was pushed from pillar to post until she was 24 weeks pregnant and given this “termination” in the form of a caesarean. So she was abused and raped all over again by the Irish state. She wasn’t even afforded the status of being an incubator as I’m sure the actual machines get better care. Her baby was then taken into care. I am sure both were extremely traumatised by the ‘care' they received. Another woman who suffered a brain tumour, had numerous infections with her body failing, was kept on life support because her 15 week old baby still had a heartbeat, against her family’s wishes. And so the atrocities continue …

These are just some of the desperately sad cases that I know about. I’m sure there are many many more. Are there good individuals working in the HSE? Yes, there are. But we are talking about national policy here, not the random luck of the draw of getting a good health care provider. It should not come down to luck, respect should be guaranteed along with evidence based care and when it’s lacking there should be adequate, accountable and transparent procedures that can be accessed and properly and thoroughly followed through.

Sunday, March 19, 2017

Safety

We can’t talk ourselves into safety, we either feel safe or we don’t. There is no quick fix when it comes to feeling safe, it takes time to rewire our systems from being primarily in flight, fight or freeze; responses which are supposed to be temporary, not permanent. If the situation in which we find, or have found, ourself is chronically and repetitively threatening (very common in early developmental trauma which often leads to complex traumatic stress syndromes), these survival responses become essential, we don’t have the luxury of turning them off, they are needed for our very survival.  However, when they are employed long term they take a huge toll on our systems. Learning how to feel safe again is about being able to determine a real threat from a perceived or imagined threat. Both threats feel very real and have the same responses in our organism but usually only the real threat requires immediate action. When we internalise a threat, or threats, that’s trauma.

Somewhere along the line we started distancing ourselves from our instincts in order to appear more civilised, many humans forgot how to discharge the freeze response (tonic immobility), and as a result, these responses often become the enemy, or the threat. This is why saying that trauma is in the past is just not true. Traumatised people live with a present and current sense of internalised threat which can be excruciating as brain research shows.



Just like love might be our ultimate goal, so might safety. But there are stepping stones on the way to these bigger goals that can empower us and make us feel good on our journey. We don’t have to have 100% safety or love in order to feel ok. For example, when tapping you might ask yourself where in your body do you feel calm, grounded or neutral. What you’re looking for is to find a place that feels safe enough to go to if there are other sensations in your body that are too much for you right now leading to overwhelm and flooding. Peter Levine calls the movement of our attention from a place of overwhelm to one of neutrality or calm, or contraction and expansion, pendulation, and it is a really great resource to use at any time.

Try tapping on:

Even though I feel a lump in my throat, I also notice that my left knee feels quite calm and I’m going to move my attention back and forth between the two

Even though it feels better to let my attention rest on my knee for now, there’s a part of me feeling I must pay attention to my throat too, I completely accept how I feel

Even though there’s a part of me that feels I have to fix this feeling in my throat or make it go away, I’ll let my attention rest on my knee for now and see what happens

Even though I don’t feel safe (how do you know this, on a scale of 0 to 10 where are you?), there are places in my body that feel calm/grounded/neutral and this makes me feel …

Even though I don’t love myself right now, I can accept and even like some parts of me and that feels …

Monday, February 27, 2017

Tapping on trauma

Have a listen to the recent podcast from Sounds True with Bessel van der Kolk talking about trauma.


Try the following tapping script and as always, customise it for your unique situation and feelings, tapping diagram:

Even though I don’t want to (it doesn't feel safe to go inside etc.) go inside and feel these feelings, I completely accept how I feel

Even though I just can’t tolerate these physical sensations right now, I completely accept how I feel

Even though some parts of me (my feelings, my sensations) have frozen in time, I acknowledge those parts

Top of head: These feelings are in my present
Eyebrow: Not my past
Side of eye: They have frozen in time
Under eye: Because at the time I couldn’t deal with them
Under nose: And that’s ok
Under chin: It was just too much
Collarbone: Sometimes it’s still too much
Under arm: That’s why I need to go slow

Top of head: Even though I want them over and done with sometimes
Eyebrow: I want to go as fast as I can
Side of eye: So I can get rid of them
Under eye: Because they feel excruciating
Under nose: And that’s ok
Under chin: I need to feel them bit by bit
Collar bone: Because there’s an accumulation of them
Under arm: I just couldn’t feel at the time

Top of head: So I’m learning how to be with my difficult feelings and sensations
Eyebrow: And not run from them
Side of eye: And not fight them
Under eye: And not freeze them
Under nose: They need to be experienced
Under chin: Slowly, surely and safely
Collar bone: Preferably with someone safe
Under arm: I might not take this journey alone

Top of head: I might not want to
Eyebrow: It’s ok to reach out for help
Side of eye: It’s safe to reach out
Under eye: To the right person
Under nose: Who feels right to me
Under chin: It’s scary to reach out
Collar bone: I’ve done it before
Under arm: And it hasn’t worked out

Top of head: It’s hard to trust
Eyebrow: That I’ll be held
Side of eye: In all my pain
Under eye: When all I want to do is run from it
Under nose: Maybe others will feel the same
Under chin: And maybe they won’t
Collar bone: Maybe they’ll understand
Under arm: How I feel ... it's worth the risk to reach out again

Wednesday, February 08, 2017

The most effective container

In my view and experience having a relational home offers the most effective container for any dysregulation. As Bonnie Badenoch put it, we draw on our inner community in order to self regulate (soothe ourself). On the outside, it looks like we’re self regulating, but we are in fact always co-regulating, whether another person is there with us physically or not. If we’ve been relatively securely attached to our care givers and others, this gives us a fantastic solid start in life which we later draw on again and again and again. The ACE study, among many others, demonstrates the price we pay when we haven’t had this solid beginning.

So, the hard science is in, we are relational creatures who are interdependent, therefore we need each other, going it alone all the time is not good for us, but it’s like many of us haven’t got the memo. People are continually shamed for not changing, not ‘growing up’, or ‘moving on’. But without the safety and warmth that a relational home can provide, we’ll stay in whatever protective defenses we’ve developed because it just won’t be safe enough to allow ourselves to be vulnerable and make any changes that we need to make.


Being able to contain our emotions, and grow a bigger container, so we increase our window of tolerance is crucial. We’re not going to release anger for ever more, because like all emotions, we need anger in certain circumstances, but we can release the anger that has become stuck when we are triggered about certain experiences we’ve had. Wishing that we didn’t have certain emotions is futile, learning how to live with them and use them for our benefit is absolutely essential for our mental and physical health.

As practitioners we can practise all the interventions and exercises we want, but if we don’t provide a relational home to ‘hold’ any dysregulation, either in ourselves or the client, they’re next to useless. At worst we’ll project and blame the client, calling them resistant and all sorts of things, instead of taking a good hard long look at what we need to change.

Friday, January 20, 2017

Not on shaky ground

I have been doing Trauma Release Exercises (TRE) on and off since the beginning of 2012. TRE operates on the basis that the body, if allowed to, will naturally shake off the tonic immobility (freeze) response, in the form of tremors. The body will shake involuntarily for however long it needs to and this will usually be followed by deep shuddering breaths and a return to homeostasis (relaxation). Wild animals shake all the time, if they didn’t, they wouldn’t survive for very long. They would become hypervigilant, constantly responding to perceived, rather than real danger, which eventually exhausts their systems. This hypervigilance, a symptom also present in traumatised humans, makes them vulnerable to real danger because their responsiveness is not as sharp or quick as it could be if they were well rested and more able to recognise the signs of true and present danger.

Human animals have become so far removed from their instincts and wilder nature that if they were to start shaking and tremoring, some might panic and think something is horribly wrong and others might think it’s weird and frightening. Here in Ireland, when people go into shock, they’re often told to eat something sweet to help calm the shaking that naturally occurs.  So we repress the shaking out of ignorance, lack of knowledge or because we don’t want to feel embarrassed or shamed by others who don’t understand what’s happening, which is why education is so desperately needed about how our bodies, brains and minds respond to stress and how we can release that stress so it doesn’t accumulate and cause illness. I don't think there is a human alive who hasn't been traumatised so it is crucial that trauma is normalised.


As with any modality you need to proceed safely and gently and TRE is no different. In fact, in my experience TRE is even more powerful than other modalities I’ve tried. What I mean by that is that it can melt those frozen parts of us too/very quickly and we can subsequently feel overwhelmed and very agitated. This might happen after you’ve completed the exercises, not necessarily during, which is why it’s important to pace yourself and preferably find someone who you can co-regulate with. 

If you think of every time you’ve been overwhelmed or received a shock over your lifetime and you haven’t released those experiences from your nervous system, they build up, and up, and up, they’re like a volcano waiting to explode. The fuller our barrels are, the more overwhelm we can experience when we start to empty those barrels. In our very understandable rush to feel better and get rid of our pain once and for all, we can go hell bent for leather, which only ever backfires.

Recovering from trauma can’t be done alone, it is absolutely crucial to have some support for our journey. The same is true for life, we are an interdependent species, we need each other and we are trying to pretend otherwise which is not working! Most of us, worldwide, live in cultures that value and admire independence, self reliance and going it alone over being supposedly ‘too’ needy. It is probably fair to say that this point of view is more common in so-called ‘developed’ counties. You have to wonder about the standards we measure that development, sometimes I think it’s purely economical. The fact that the term needy even exists is so telling.

I listened to an excellent webinar by Bonnie Badenoch recently and she talked about the myth of self regulation. What she said really resonated with me. Most of us have come to believe that needing others makes us weak, that the goal is to be able to do everything by ourselves. But I truly believe that we weren’t meant to go it alone, just look at a little baby and how they thrive when their care giver is attuned and mirrors them or an infant that is abused or neglected and left to “self soothe”. There is some difference between the two and how their lives pan out.

The fact is, if we weren’t soothed when we were young, it is extremely difficult later in life to learn how to relax and calm ourselves, though not impossible. When we can calm ourselves as adults, it’s because we have an inner community that we can draw upon according to Bonnie Badenoch and I agree wholeheartedly. So, even though on the outside it looks like we’re ‘self regulating’, we’re still co-regulating because we’re drawing on internal resources that were shared and given with love by others. We internalise everything, the good and the bad. The care and warmth we receive stays with us, as does the neglect and abuse, until we work through it and transform it.

Sadly, some people don’t even have one warm and nurturing person that they can call upon, but maybe they have something else for the time being, such as a pet, nature etc. What is essential though, is reaching out and finding someone who is safe and nurturing, I don’t think there’s any substitute for other loving human beings in our life. I think everyone deserves and needs to have at least one person in their lifetime who provides them with warmth, validation and safety. 

A practice that I’ve found extremely helpful is pendulation. The practice is from somatic experiencing, which was developed by Peter Levine. When we swing our attention back and forth between tension and relaxation for example, we are pendulating between the two, which helps us stay with the difficult sensations a bit longer without becoming overwhelmed. I often do the constructive rest pose (which is from yoga and very similar to the position in TRE at the end of the exercises) and if I notice my legs starting to tremor, much more gently than if I had done TRE, I know my body is releasing some stress. To help with any possible overwhelm and to help co-regulate my system, I scan my body to find a place of relaxation or a place that feels neutral and swing my attention back and forth between the shaking and the neutral/relaxed place which works really well. I also plant my feet firmly on the ground so even though my body might be shaking, I’m not on ‘shaky ground’. I push my feet firmly into the floor as many times as I need to in order to ground myself and feel more regulated. 

Wednesday, January 11, 2017

Let a feeling crack you open

I wanted to share this excellent post by Jeff Foster on feelings. I think this is what any good therapy, or life, ultimately and eventually teaches us: not to fight/resist/avoid/numb or dread our feelings. I know it's not easy to learn how to do this, in fact it's excruciatingly hard sometimes, but I believe it is essential. You can find out more about Jeff here.




Tuesday, December 13, 2016

A resourcing exercise

I learned this resourcing exercise last month from Jess Angland, who is an excellent facilitator. Write down all your external resources on different pieces of paper and include 3 or 4 things about why that particular thing/person resources you. Your resources can be anything at all. For example, you might pick nature and say it resources you because it's calm, beautiful, you can be yourself, it energises you and so on.

* click on image for bigger size

Look well into thyself; there is a source of strength which will always spring up if thou wilt always look ~ Marcus Aurelius

Then write down what your internal resources are. It doesn't matter how many resources you come up with, what matters are the resources you have now and drawing on them when you need them. Sit on a chair and put the pieces of paper you have written on all around you and see how this exercise makes you feel. Usually you will feel more resourced than you think, but of course it can also bring up what we really want and what we don't have and that's ok too. You can tap on anything that this exercise brings up for you.

Monday, December 05, 2016

The container exercise

I’ll say right up front, I don’t like the container exercise and have never used it with clients. If you don’t know it, it’s where you put things that are upsetting you (supposedly temporarily) so you can go back and deal with them later/at a more appropriate time. The container can be any receptacle that you can imagine, any size, colour etc. This tool is used, in my opinion, for the therapist, not the client.

If only our minds and bodies were as neat and tidy as keeping things in a container until we’re ready to deal with them. There are two main issues I have with this exercise and they are 1. triggers and 2. the inability or unwillingness of a practitioner to wade into the swamp with us. Just because something is in a container and we’ve put it on planet Mars, doesn’t mean we’re not going to be triggered by what’s inside it between sessions or at any time for that matter. What we really need are self regulating skills in order to help calm and soothe our nervous system not more tools to help us dissociate and avoid (which it says it’s not for, but that’s what too often happens), many of us are already excellent at doing that. We also need what Robert Stolorow calls; a relational home, so don’t settle for anything less in therapy.

The real reason I’m writing this post though is because this tool was used with me this year and I informed the practitioner of my opinions about it. I was willing to give it one more go just in case it worked this time (against my better judgement) and also because he wasn’t listening to me nor was he taking my concerns seriously, so I fell into the trap of people pleasing. It’s obviously a tool he uses a lot and he did not seem open to not using it or using something else instead.
The issues inside my container kept ‘leaking’ of course, because they need and want to be heard and this was not taken to kindly by the practitioner. He got frustrated with the fact that I wasn’t behaving, i.e. leaving things inside my container so he could get on with the resource work. Only trouble is I didn’t feel resourced and he just wasn’t able to handle this fact. Seems he missed the memo that I was supposed to be the one being resourced and the very basics of any therapy; listening, was missing. This is called countertransference in therapy and it is not a case of if but when it will come up, so all practitioners need to be willing to deal with it.

Clients can often become a performing monkey in order to massage a practitioner’s ego, instead of being true to themselves and being firm about what works and what doesn’t. I stayed firm in my knowing that this particular tool just doesn’t work for me. I had given it the umpteenth chance in order to prove I wasn’t “stubborn” or “difficult” (a covert form of people pleasing). Always, always, trust your instincts/gut, you’ll be so glad you did. I think the person we're most often angry with is our self when we don't listen to that voice.