Depressed or Just Pregnant?

I just wrote a paper called 'Drinking the Pregnancy Lemonade: Medical and Societal Denial of Prenatal Depression'. Part of the paper discussed the challenges of diagnosing depression in pregnant women, because of the overlap of symptoms. I thought you might this funny.


DSM-IV TR: Major Depressive Disorder vs. 

What to Expect When You're Expecting



Criteria: dysphoria and anhedonia...


Normal mood swings of depression can take your emotions places they've never gone before, both to exhilarating highs and depressive lows... Pregnancy can be a time of high anxiety... a certain amount of worry is normal, and probably unavoidable. (p.165)


..and four of the following every day for at least two weeks, combined with distress/impairment in functioning: Significant weight or appetite change,


From the fourth month on, start watching your weight
to make sure it begins to move upward at the appropriate rate...(p. 181) 


Insomnia or hypersomnia,


Sleep problems are common in pregnancy, and...
may be good preparation for the sleepless nights that lie ahead once your baby arrives... (p. 204)


Psychomotor retardation or agitation,


15 percent or so of pregnant women...experience restless leg syndrome... (p. 289)


Fatigue or loss of energy,


Physical or mental fatigue can... exacerbate the symptoms of morning sickness
(conversely, severe morning sickness can increase fatigue). (p. 131)


Feelings of guilt or worthlessness,


Dreams of... being unprepared for the baby when he or she arrives can reveal the common fear that you're not up to being a mother... Dreaming about becoming unattractive or repulsive to your spouse...expresses the common fear that pregnancy will...
make you unappealing to your partner. (p. 292)


Reduced ability to think or concentrate,


Like numerous other symptoms, forgetfulness is caused by the hormonal changes of pregnancy. Sleep deprivation can also play a role (the less you sleep, the less you remember)... (p. 215)


Recurrent thoughts of death or suicide.


Topping the list of most common concerns, understandably, is a fear of miscarriage.
Fortunately, most expectant worriers end up worrying unnecessarily. (p. 140)



Editing birth stories in my spare time.

Since I'm not on Facebook, and I'm not blogging very much, and I'm not tweeting hardly ever, and I haven't checked my phone messages in a week, I thought I'd let you know what we've been up to.

Zu is doing all his Zu stuff (cooking, cleaning, working full-time, putting out - being a good housewife), Tiyo is doing a lot of hammering and has learned a new word (starts with 'n', ends with 'o', www.thetuesdayphoto.wordpress.com), and I'm still seeing clients and doing my backlog of schoolwork editing birth stories. Yes, I think I have found my life's calling. I am a born birth-story editor. I love love love love it.

I've been working for January at Birth Without Fear, which is pretty much the best birth blog you'll ever lay eyes on (it even won an award!) and publishes several birth stories a week, usually on a daily basis. The idea is to build a repository of real birth experiences and a community of birth/health advocates, to bring some balance to the strange misconceptions our society has about birth, women's bodies, pregnancy, and how it should all be done lying down.

Lithotomy Position from The Business of Being Born doc

My job is to read women's stories, edit them for clarity and grammar, and insert the beautiful pictures that have been sent in. It's simple but it feels good, and it fits in well with the chaos of daily life around here. It's a job that can be done in fits and spurts, and I can leave it and pick up where I left off. Often, it makes me cry.

Here are some of the stories I've worked on:




I am consistently blown away by the strength of the women writing these stories, their love for their babies, and the commitment they have, often in the face of institutional disregard, to the birth process. Some have natural births, some have cesareans; some birth their babies alone in a tub of water and others invite their whole families. There is a range of possibilities for birth, but it always has the possibility of being a profound, spiritual experience. I haven't written up Sweet Baby James' birth story, but I'd better do it sometime in the next six months...

I've also been writing articles for Birth Without Fear, about the fear-mongering and faulty logic in anti-bed-sharing campaigns, the need to look after postpartum mothers, and the controversial Quebecois 'Moi Aussi, J'allaite' breastfeeding campaign.


Oh, and I starred in this independent film.



You don't have to feel grateful. Happy Thanksgiving!

There is something very peaceful about today. Baby bear is sleeping in his little bed, in the walk-in closet we recently converted to a (very small) bedroom. Papa bear is sleeping in 'Big Bed' (we don't call it 'our bed' - it's not). My usual morning clients rescheduled and I got two hours to myself instead.

Today is American Thanksgiving. In Canada, Thanksgiving happens in early October and it's pretty much just a day to get dumped, since it's the first long weekend after the start of the school year and young people come back home from college to break up with their high school sweethearts. Some like to call it 'Turkey Dump'.

But it's a really big deal down here. Papa bear says it's the biggest American holiday, that the day before Thanksgiving is the highest travel day of the year. Our conversation this morning went like this:

Mama: It's not the biggest, Christmas is. For sure.
Papa: It is the biggest! Everybody celebrates it!
Mama: Not Jews. Sela doesn't celebrate it.
Papa: Well, not practicing Jews, they only celebrate holidays on their own calendar. But everybody else.
Mama: Do Mormons? I just wished a Mormon Happy Thanksgiving.
Papa: Yes. Of course Mormons. I'm telling you, you can say 'Happy Thanksgiving' to basically anybody. It's not a religious holiday.
Mama: Yeah well, I said 'Happy Thanksgiving' to my prof and she said, "I'm Cherokee."
Papa: OK. Not everybody celebrates it.

Then I went to get the diapers from the laundry.

I could write something about anti-colonialism, but today I'm just thinking about gratitude. Gratitude is a complicated thing. I remember hearing once that, "Where there is gratitude, there is no neurosis." And  I think that's probably true.

But people get confused. They reverse it – they think that if you can just cultivate the Attitude of Grattitude™, you can eliminate the neurotic parts of yourself. I'm not so sure about this. When I was really unhappy, reminders to be grateful just felt like a slap in the face. I knew I was lucky in some ways and totally privileged in others. But knowing that did not make it easy to get up in the morning or to look myself in the mirror. If anything, it just felt like, "I'm such a jerk to be so unhappy when I have so much."

Gratitude is like the warmth of sunshine. It comes with happiness. And it doesn't cause it. It's a lucky by-product of feeling good in your skin, feeling loved and secure. My life is different now, and I can't help but feel grateful, many times a day, for my husband's broad shoulders, my son's smile, his good health, his obsession with all things carpenter.



Remember when people used to tell you to do positive affirmations? To look in the mirror and say, "I am beautiful, I am happy, I am the best me I can be," crap like that? Research came out a few years ago saying that if the person doesn't already feel pretty good about themselves, positive affirmations make them feel worse. They remind you of how much you actually think you really suck. Plus, that kind of cognitive dissonance (believing two opposing things at the same time) is stressful.

So anyway. Today I give thanks, but I don't encourage others to do the same. If you don't feel grateful today, that's OK. You can feel grateful later. For now, maybe just see if you can do something to remind yourself that you are loved.


Elder and little one at a 2009 candle-light vigil for Tiffany Morrison.





We don't need to teach our kids pretty much anything. And, a blog I love.




I read this in my inbox this morning. It's from nurshable.com, a blog I love. I don't agree with everything Sarah, the blogger, says, but she sure is one fantastic mom (see how that works? We are not the same person, but I like her anyway?). She took Google Adwords off her blog because there was no way to prevent creepy formula ads from showing up. And her posts show that real gut-level psychological insight that can be so lacking in parenting discussions.

Her blogs are all written as letters to her little ones (I think she has three, or something amazing like that). Writing to her 7 month-old daughter who was once classified as a picky eater (by others), she says,

"With your brothers when they started eating purees the food came out in their poop undigested. I was told that their systems were "just getting used to it". They would nurse constantly like they were going through a growth spurt as their bodies could make no use of the stuff that filled up their bellies and then they'd have to catch up with milk later. It felt completely wrong, but I figured it was like walking and it needed to be taught. See the problem there? Walking doesn't need to be taught either."


I couldn't agree more.

Pregnant and Friendless: On getting knocked up and quitting Facebook (again)

So. I have some news.

First, I'm pregnant. Second, and perhaps more life-changing, I'm leaving Facebook.

Let's start at the beginning: pregnant means we're expecting another baby! It might be a boy and it might be a girl! It might also be intersexed! I'm about 11 weeks, which means the little one should be arriving sometime in mid-May – perfect because that's when Zu's done teaching his classes and he's all mine for the rest of the summer. I'm excited for SBJ to have a younger sibling and, although it postpones my plans for world domination by at least two years, I feel blessed to have the chance to raise another baby. This time, I know what I'm doing.

Right.

And Facebook - dear, darling, Facebook. How I have loved thee... I used to be a huge Facebook supporter.
I wouldn't have my baby, my foetus, or my husband if it weren't for Facebook. He was an acquaintance I tagged in a picture of graffiti. Then he moved to Montreal.
I've loved connecting with old friends and teachers I surely would always otherwise have wondered about.
Through it, I managed and promoted Studio Béluga, a 'self-pedagogical creative community' in a warehouse in St. Henri, and it was amazing.
I was an active member of several mommy-groups, and I learned so much about pregnancy, birth, parenting and group dynamics. I also made some good (but alas, digital) friends.

But now I'm not promoting or managing anything (except my toddler). I'm not looking for a mate (or, more accurately, teasing good-looking bald writers who live in New York). I got bored with my mommy-groups at about the 50th conversation about when to introduce solids; and the old friends and teachers, well... I will miss them.

I've been off Facebook for more than a week and here's what I don't miss:

  • Hearing, on a daily basis, about the bad things people do to their kids. No, I don't think it's OK to leave your child crying for five hours. Sorry.
  • Overwrought conversations about American politics, vaccines, autism, the supposed (and debunked) connection between vaccines and autism, how mental illness should be managed entirely through herbs and positive thinking, how ADHD 'doesn't exist' and how pregnant women should not be allowed to drink coffee. Even decaf, "because of the chemicals".
  • Somehow not ever receiving my closest friends' notifications. At some point, Facebook decided that I'm a MOMMYMOMMOM (how could this be? ....) and began to exclusively update me about other moms on my friendslist. It's fun to know that the girl in your grade 10 English class has two kids and lives in the UK; it's fun to see how other moms are living out their lives in perfect Pinterest fashion, and it's fun just to know you're not the only middle-class mom in America who does not have an irrational fear of her toddler starving to death. But most of the people I really wanted to hear about - the old roommates, the artists, the adventurers, those who dwell in my heart - don't have kids yet. This doesn't make them less interesting to me, but Fb never seemed to get it.
  • The best self phenomenon. They say that people only portray their best selves on Fb, and that this makes everyone else feel insecure and unhappy. But I think the truth is the inverse: it's not that people are reluctant to admit that anything is wrong in their lives; it's that doing so is seen by the Fb community as inappropriate, kind of... gauche. Like, don't share that on here, I'm looking at pictures of cats stuck in window blinds. 

    The Fb environment encourages - nay, demands! - your 'Best Self'. A significant moment in my falling out of love with Facebook: I had to take my newborn into Children's Hospital for surgery on not one but two hernias. Given the mounds of love we'd received in announcing his birth and posting his pictures (hundreds of likes! I was so touched!), I expected people to be worried. You know, post some sympathy. I got one compassionate message, and a dear friend sent us a delivery gift basket. But overall (aside from a joke, 'was he moving furniture?', and, yes, a few condolences) the silence was deafening. And here's the rub: I know that each and every person who congratulated me on SBJ's birth would be sympathetic and supportive if I called them up and said he was in the hospital for surgery – but when your little one's intestines are protruding in a mass (two masses!) outside of his belly, it's just not something to talk about on Fb. This sucks.


There was a time when Facebook was 'right' for me. I don't expect all my friends to quit. But can I tell you what I really think about it? Will you get offended?




I think an active Facebook page and a spiritual life are mutually exclusive. I'm not entirely sure of the mechanism behind it (does it change your brain and the kind of stimulation you need in order to feel alive? Does it simply take up all your 'free' time that would otherwise be spent in spiritually fulfilling tasks?) but a few ex-Facebookers I've spoken to have also found this to be true. You can't 'like' the divine, and you can't 'share' your way to Nirvana.

Technically, it need not be. Technically, I should still be able to meditate, breathe deeply, go for walks, dream, journal, pray, and be fully present with my loved ones even if I spend an hour or more on Facebook each day. But it doesn't happen.

In the first week I was off Facebook I got a lot of tasks done. I started making a list of all the awesomeness I was experiencing IRL (crepes, bread pudding, pumpkin carving, laundry...) but the most important change has been deeper. My dream life. I hadn't really had profound dreams for at least a few years, and I was secretly blaming it on motherhood ("What happens to the dreams of sleep-deprived new mothers? Where do they go?" - Adrienne Rich), or just being happier and more settled in my life. I was secretly a little worried.

But now, without the Fb chatter, my subconscious mind is doing things again. Lots of problem-solving and plot-lines based loosely on The Wire, but also some deeper stuff: a week ago I had a dream that I came to peace with an old ex (and met his new love. She's a little young but a lot amazing!), and last night, with a former co-worker (we shopped for earrings). I think this is a good thing. When I look back at my life, this is what I want to see. I want more of this...



And less of this.



I miss my Fb life. Since I'm planning to keep my profile up so that people won't think I've de-friended them, it sometimes feels like a whole other Svea is carrying out a whole other life somewhere else. It's strange to know that my data is still being kept and my newsfeed is still being generated. All just waiting for the day when I cave and come back. Because, you know...






I'm not the first person to leave Facebook. At least two other people have done so:









Shibori Healing - Group Therapy for Mothers Pregnant After Loss

I just got back from my second residency at Goddard College, Vermont. I'm doing an MA in Counseling and Psychology (to complement the diploma in psychotherapy I finally completed this summer) and it's pretty much the best thing ever.

My advisor, Wendy Phillips, is an intellectual badass and heartbreaking visual artist. She curates an art show each residency to showcase the work of students throughout the program. Because the program is so very much DIY, there's room for creative work in a way that I haven't found anywhere else in academia. As Wendy says, "I keep thinking they're going to come in and tell me 'You can't do that!' But they haven't yet..."

I exhibited a prototype from a workshop I designed last semester in my course on group therapy. You may have noticed I'm interested in maternal health (ya don't say?), so I wrote my final paper on this idea: designing a hands-on workshop for mothers pregnant after experiencing loss. The product of the workshop would be a baby-carrier, dyed through the traditional Japanese art of Shibori.

Shrouded Shibori by Holly Brackmann


Social support is so important in facilitating the movement through grief. And I feel that the process of working with textiles is something akin to the process of creating a baby: painstaking in one way and yet so comforting as well; following a pre-determined design but also touching an element of the unknown; and in its cultural coding, entirely feminine.

I posted a link to my residency write-up on my Fb page and there was some interest in reading a bit more about this project. So here's the paper I wrote, interspersed with some screenshots for the workshop, which will probably never happen but was really fun to write about.



Shibori Healing: Textile-Based Group Therapy for Mothers



Introduction:
The relationship between parent and child is one of inter-dependence and shared identity; the grief experienced from its loss is almost necessarily 'pathological' in nature (Rando, 1993). Perinatal death (the loss of a child1 at or around the time of childbirth) is experienced by the parents as a profound tragedy with existential ramifications reaching the very core of self-understanding (Taubman-Ben-Ari & Katz-Ben-Ami, 2008). Societal treatment of parents who have lost an infant, however, does not often acknowledge the magnitude of this grief (Rando, 1993). In addition to the pain of loss, mothers report feeling stressed, isolated, and misunderstood.
The situation becomes further complicated when a mother who is suffering from perinatal loss becomes pregnant again. Carrying her 'Rainbow baby' within her, she may experience relief from some of the most severe symptoms of her grief; relief may also bring guilt. Outsiders might congratulate her on 'becoming a mother again' or anxiously refrain from discussing her past pregnancy for fear of causing 'bad luck'. Extra medical attention may feel warranted, or it may increase her anxiety. She may worry that she will not be able to bond with her child.
The intersection of stress and joy at the prospect of a new child, and remaining grief and fear from the loss of a previous one, is an area particularly dense with psychological need. Therapy designed specifically for mothers in this situation, however, is almost nonexistent. The benefits of designing an effective therapy for this population could have long-term positive effects: the anxiety and depression experienced by mothers after perinatal loss can also interfere with their level and style of attachment to the new child (Gaudet, 2010). Mothers who receive counseling and social support undergo shortened bereavement reactions after perinatal death (Forest, Standish, & Baum, 1982). Therapies that address this issue with mothers pregnant again may enhance their abilities to relate with their children.



Issues Associated with Carrying a Rainbow Baby: Terminology
"Rainbow Babies" are the understanding that the beauty of a rainbow does not negate the ravages of the storm. When a rainbow appears, it does not mean that the storm never happened or that the family is not still dealing with its aftermath. What it means is that something beautiful and full of light has appeared in the midst of the darkness and the clouds. Storm clouds may still loom over but the rainbow provides a counterbalance of color, energy, and much needed hope (starwarsmama, 2010).

The terminology used to describe a deceased child is laden with emotion, reflecting the light through which the speaker wishes both the child and their passing to be seen. One comment thread recently posted in the Facebook group, 'Defiling Photos of Dead Babies is NOT ART!' (created by a bereaved mother with the intention of pressuring the creator of the 'Stillborn in th3 USA' series to redact and apologize for her work), discussed the issue of the group's title. A group member took exception to it, stating that, “I am only speaking for myself but the name of this group bothers me in that its name contains the phrase "dead babies" which I find offensive. My child may have died but I would never refer to her as my dead baby” (Leif, 2012).
The term 'rainbow baby' is used to denote a child born after parents' previous experience of the loss of a child to miscarriage, stillbirth, or other fatality. Like 'angel baby' (a deceased child), the term is ambivalent, referring both to joy and grief. Mothers use it to express the healing power of re-engaging in processes of child conception, childbirth, and child-rearing.
The term, however, has not been adopted by medical professionals, who seem more likely to use the rainbow metaphor to market their services as child-friendly (e.g. the University Hospitals 'Rainbow Babies and Children's Hospital' in Cleveland, OH) or in reference to the adopted children of LGBTQ couples. Even within parenting loss support groups, the rainbow metaphor has its detractors. Some Christian mothers find it denies the goodness of God; others find its additional association with LGBTQ causes distressing.
Uses of 'Rainbow baby' must also be seen within the context they occur: the lexicon of parenting groups, many of which use a register that is cutesy and decidedly non-medical. For example, other terms include, 'BFP' (Big Fat Positive, a positive pregnancy test), 'Sticky dust' (wishes or prayers for a healthy pregnancy not leading to miscarriage or loss) and 'DTBD' (Doing the Baby Dance, or having sex). The success of these parenting groups may indicate that American women feel a need to pursue advice and support regarding reproduction outside of the medical field.




Issues Associated with Carrying a Rainbow Baby: Ostracism
I'm sorry you can't see him, but I feel him always, all around me. He's definitely here. I'm not contagious. It doesn't rub off. Why do people freak out when Caleb's name is brought up? Why do certain members of my family completely ignore he ever existed? Why have long time friends just up and block [sic] me from their lives? I don't believe I've been a self pity party. I think I've done quite well. So what's the big deal? Everyone freaked out about death that much? (Evans, 2012)

The social isolation that often accompanies the loss of an infant can have devastating effects (Doka, 1989). Parents experiencing intense grief without knowledgeable support can feel that they are losing their minds (Rando, 1993). The dramatic change in social role that accompanies pregnancy (Taubman-Ben-Ari & Katz-Ben-Ami, 2008) and its subsequent loss in the case of perinatal death can lead to uncertainty as to how to interact with the world (Gaudet, 2010). It has been hypothesized that strangers, friends, and even close family members do not develop the same kind of attachment with a child in-utero as the parents (Rando, 1993). Thus, their need to grieve the loss of their unborn or stillborn child is never fully understood.



Issues Associated with Carrying a Rainbow Baby: Depression and Attachment
It's rough but we're just trying to get by. I think it will be harder on me as it gets closer to February and...[our earlier son's] birth/death date, and when (if) I'm in the 3rd trimester or whatnot - just movement might be hard. I may have a really hard time "bonding" with the pregnancy, for sure. I think i might really hold back (ekandrmkb, 2011).

While it is important and valuable to provide emotional support for grieving parents, efforts to address the emotional complications present in post-loss pregnancies also have a broader significance. Infants of mothers with clinical depression, particularly during the last trimester, are more likely to show disordered capacity for neurorelugation (Goodman, Rouse, Long, Ji, & Brand, 2011; Glover, Bergman, & O’Connor, 2008) marked by infant disorganization and fussiness in general (Hart, Field, & Roitfarb, 1999; Lundy et al., 1999; Zuckerman, Bauchner, Parker, & Cabral, 1990).
This can set a negative stream of interactions in motion, as emotionally withdrawn post-loss mothers face the additional challenge of bonding with a fussy baby (Goodman, Rouse, Long, Ji, & Brand, 2011). Some researchers (ibid.) have recommended that healthcare providers monitor women they perceive to be at greater risk for antenatal depression, assessing their infants for fussiness and helping mothers learn coping and calming mechanisms in caring for their newborns.



Issues Associated with Carrying a Rainbow Baby: Medical Management:
When I labored with my first I was told I was incapable, that my body “couldn’t” do it, that my contractions were inadequate, that I wasn’t dilating fast enough, then that I couldn’t push him out. I was forced to have medicine that almost killed him by putting him into severe distress, then I was forced to have him cut and sucked out of me because of my “inadequacy” (Renee, 2011).

Women with access to healthcare are often monitored more closely in post-loss pregnancies. In many cases, the causes of previous stillbirth or miscarriage remain unknown and the medical management of the subsequent pregnancy is pervasive, conducted as a matter of course. Women have conflicting feelings about this management (e.g. LRusso, 2012; Renee, 2011). Some find that increased management allays some of their fears and validates their efforts to provide a safe environment for foetal growth (LRusso, 2012). Others find it invasive, exacerbating their fears of worst-case scenarios (Renee, 2011). And still others feel that their pregnancy is not being monitored closely enough.
Like patients with medical illness, pregnant women interface with medical procedures and professionals on a regular basis. Their feelings about this involvement must be taken into account in the design of further healthcare therapies, including psychological work.



Issues Associated with Carrying a Rainbow Baby: Pregnancy as a 'Coping Mechanism':
I don't know if since Carys' arrival if I have had much time to remember Jayne, of course I still think about her every day, but Carys keeps me so busy, I'm not sure I'm able to continue to process the grief in the same way. Is this a good thing? Is this the next stage, integrating Jayne into a family that's here with me? Or ought I to make a space for my relationship with Jayne? A time for just me and her? How does anyone else manage mothering rainbows and angels?(JulyBaby, 2010)
Little or no research has been conducted into the reasons behind and factors contributing to the decision to have another child after perinatal loss. While there are mental health contra-indications for becoming pregnant soon after, such as increased risk for anxio-depressive symptoms (Gaudet, 2010; Forest, Standish, & Baum, 1982), an estimated 86% of women become pregnant again within 18 months of suffering perinatal loss (Cuisinier, Janssen, Degraauw, Bakker and Ogduin, 1996). Many women fare better having devoted more time and energy to exclusively grieving a lost infant (Forest et al., 1982); but most do not take this path.
Research literature frames quick re-engagement with the reproductive process as a 'coping mechanism' (Gaudet, 2010; Wolff, Neilson and Schiller, 1970) with a risk of 'replacement baby syndrome' (Gaudet, 2010). Pregnancy after loss may in fact be an added complication in an already labyrinthine grieving process (O'Leary, 2004). It has been found to dampen some aspects of grief, including the loss of self-perception as mother, the loss of social role as mother, and guilt (Lin & Lasker, 1996; Theut, Zaslow, Rabinovich, Bartko & Morihisa, 1990).
Women in online support groups almost universally agree that the decision of when or if to have another child is a complex and personal one. The very concept of 'rainbow baby' indicates that the mother may currently be experiencing intense grief while also welcoming a new child into her life. The belief that the next pregnancy should come only after the first loss has been 'fully grieved' is one that is found more frequently within the medical literature (O'Leary, 2004; Côte-Arsenault, 1995) than the statements or actions of mothers themselves.
And yet, healthcare professionals continue to make that recommendation (Gaudet, 2010; Forest et al., 1982). Such statements about the morality of reproduction (who has a right to bear children, through what means, and with what frequency) are often perceived differently from the perspectives of a healthcare provider and a patient. An assumption that women are persons with agency should lead healthcare providers to facilitate women's choices instead of dictating them. Therapeutic support for the vast majority of women who are pregnant soon after loss is an ethical imperative.



Shibori Healing Group Worksop: Overview
This paper accompanies an eight-session workshop entitled 'Shibori Healing: Textile-based Group Therapy for Mothers'. In this short-term therapy, pregnant women who have previously experienced perinatal loss are encouraged to discuss, learn about, and support others in the various elements of the grieving process. At the same time, they are encouraged to look forward to meeting and raising their new child, to foster an attachment with him/her, and to consider how their experience with loss will both present challenges and provide special meaning to the process of raising a child.
The workshop takes its cues from other support groups (Alcoholics Anonymous, Mothers Against Drunk Driving) but asks questions more often heard in interactional group settings, such as those of an existential nature (Yalom, 2005). 'Shibori Healing' does not rely on the agenda-like structures often used to facilitate support groups; instead, it makes use of the long-standing tradition of communal women's work. Shibori is an ancient Japanese cloth dying technique which is process-intensive and yet easy to learn. With each workshop session, participants are invited to learn and talk about suggested topics while they work on their pieces.
While the technique of Shibori dying does not have special significance to this topic, the assigned textile piece connects intimately with attachment and hope: participants create a baby-carrier for their new infant. 'Babywearing' is both a traditional and contemporary practice which has been shown to increase levels of bonding and attunement between parent and infant (Johnson, 2010; Anisfeld, Casper, Nozyce, & Cunningham, 1990). It is hoped that the act of creating a simple carrier within a safe and supportive female community will foster trust, self-confidence, and a feeling of belonging. The tangible product produced at the end of the workshop may also be experienced as an expression of the participant's growing confidence that the child in-utero will soon be held closely within it.
Reflecting the popularity of online support groups addressing all issues of parenthood, 'Shibori Healing' also takes advantage of the advent of social media. A private online discussion group specifically designed for workshop participants will be made available, lightly moderated on a daily basis by the workshop facilitator. According to statements made online, mothers who participate in online groups designed to support them through perinatal loss often experience them as life-changing, in some ways more intimate than their relationships 'IRL' (In Real Life) (Evans, 2010). It is hoped that the online group will provide another avenue for social support.



Shibori Healing Group Workshop: Technology
People who were once my friends have pushed themselves away because they don’t know what to say, they don’t know how to act. Normal activities like taking a shower, eating and driving to work are no longer the same. But then, God sent me gifts...Friends who really get it. Friends who understand how it feels. And although I would never wish this upon anyone, I am elated to have met some of the incredibly amazing women who have been sent to me...By forming these exceptionally strong bonds with women I have never met, we are honoring our babies. We are celebrating their lives and we are each strengthened by one another (Evans, 2012).

The rise of social media has impacted the normal process of grieving for a lost child. While parents continue to face the challenge of social awkwardness and even ostracism from their friends and family (Rando, 1984), they now have the option of participating in one of hundreds of online parenting and grieving support groups. Many of these groups have secondary affiliations through which parents can further connect and receive support: religious beliefs, the age at which the child died, or the means through which the death occurred. Participants are encouraged to discuss the details of their child's death, the ways they experience and cope with grief, and post pictures of their deceased children.
Almost all of these groups explicitly share the intention of supporting members in their grieving process, helping them to feel that their grief is accepted and validated.2 Stories of miscarriage, stillbirth and infant death are often greeted with long comments of commiseration, transcriptions of prayers made on the initial poster's behalf, and stories of healing from mothers who have experienced the same. These new networks of support offer help in the form of suggestions for burial rituals, trained volunteer guidance, pen-pals and intangible, technologically-mediated human comfort.



Shibori Healing Group Workshop: The Value(s) of Cloth
Cloth, by its very nature and function, occupies the transitional space between the boundary of the self and the other, individual and social, private and public. For the newborn infant, cloth literally becomes a secondary holding environment, and the first experience of feeling mother; of comfort, safety, and warmth… or lack thereof. For this reason, textiles provide what Bion and Winnicott termed a ‘containing environment’. In psychological terms it is this environment, usually created by the parents, where the infant feels held by another (Kalaba, 2011).

The practice of 'babywearing' has been shown to enhance attachment between infants and caregivers (Johnson, 2010; Anisfeld, Casper, Nozyce, & Cunningham, 1990). The carrier produced in this workshop is simply a rectangle of cloth held together by two rings. While participants will be encouraged to become acquainted with and consider using the practice, babywearing itself is optional. The simplicity of this carrier's design allows the cloth to be used for other nurturing purposes: to swaddle the infant (which could help to calm infants perhaps in extra needs of such containment, if their mothers experience pre-natal depression, as discussed above); to keep the infant warm; to reduce distraction during breast feeding if the mother chooses to do so; and so on.
Traditionally, 'women's work' in the Western world has engaged with cloth, producing textile-based objects imbued with psychological meaning. This has been done through the communal and hands-on production of crafts, clothing, and house décor. The modern stereotype of a mother endlessly and endearingly attached to cloth items of special significance, such as an infant's first outfit, may be seen as a continuation of this tradition.
While Winnicott (1957) first touched on the psychological importance of its nurturing, corporeal nature, psychology as a discipline has shied away from studies of cloth. The use of textiles in supporting people through grief has been left to the exploration of community-based projects, most often run by women who have themselves experienced loss. Little Angels Hankies, in which a handkerchief is embroidered with the name of a lost child and then sent to the grieving family free of cost, is one example. Collecting Loss, in which family members contribute clothing worn by a deceased loved one for public exhibition is another.
The use of cloth in 'Shibori Healing' is an effort to continue this small body of work. It is hoped that engagement with textile production will help participants to deeply and tactically engage with the concepts most difficult for mothers who have suffered loss: the felt sense of being a mother; the urge to both create and inhabit safe, womb-like spaces; and the desire to hold a healthy baby in her arms.



Shibori Healing Workshop: The Importance of Group
The group format of this workshop was selected for a number of reasons. The first is simple social validation: participants will be exposed to others experiencing many of the same events (what Yalom (2005) calls the 'principle of universality'). Through this, participants experience a reduction in feelings of isolation and anxiety. The second reason is community.
Historically, Western women engaged in manual labour in close proximity to each other. Time spent with close female kin allowed the transfer of traditional knowledge (Gorer, 1949), especially with regard to parenting techniques and values. Current cultural fragmentation and industrial advances have made this forum all but impossible. The proliferation of online mothers' forums demonstrates that modern women need social advice-giving and support forums (both online and in real life) more than ever. Lastly, the group format has been found to be particularly helpful in addressing existential concerns (Yalom, 2005).
Some theorists have posited that mothering an infant serves not only to transform a woman into a mother, but also as a buffer against her natural death anxiety (Taubman-Ben-Ari & Katz-Ben-Ami, 2008; Deutsch, 1945). The experience of birth itself increases a mother's access to her unconscious ideas about death (Westbrook, 1978). With the loss of a child, the mother is thus forced to confront mortality in a number of ways. Yalom (2005) explains that group therapy has a special ability to deal with such existential issues, helping participants to recognize that, “...life is at times unfair and unjust...ultimately there is no escape from some of life's pain or from death” (98). The chance to face these issues not in isolation, but in a supportive group setting, could be helpful for grieving parents.



Conclusion:
'Shibori Healing' was initially intended to fit within the framework of therapeutic expressive arts therapeutic, as put forth by Paulo Knill, Ellen Levine and Stephen Levine (2005). But in this workshop, the visual elements of the cloth dyed and sewn are not considered the expression of inner psychological workings. On further reflection, it was understood that 'Shibori Healing' and perhaps therapeutic work in producing textiles in general, speaks to a different understanding.
The production of textiles almost always involves repetition and the fulfillment of a predetermined design. In 'Shibori Healing', the emphasis is put on repetitive, body-based tasks intended to allow space and time for psychological transformations to occur. These transformations can then be expressed and integrated in other areas of the client's life, but are not likely to be evident in the patterns of the shibori cloth itself. The product of this therapy is both functional and relational: loss experienced in the past is carried forward, embedded within an object that can also carry new life.





References:

Anisfeld, E., Casper, V., Nozyce, M., & Cunningham, N. (1990). Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment. Child Development, 61, 5, 1617-1627.

Côte-Arsenault, D. (1995). Tasks of pregnancy and anxiety in pregnancy after perinatal loss. Dissertation Abstracts International, 56, 66–69.

Cuisinier, M., Janssen, H., Degraauw, C., Bakker, S., & Ogduin, C. (1996). Pregnancy following miscarriage: Course of grief and some determining factors. Journal of Psychosomatic, Obstetric and Gynaecology, 17, 168–174.

Deutsch, H. (1945). The psychology of women: A psychoanalytic interpretation. Volume 2: Motherhood. New York, NY: Grune & Stratton.

Doka, K. J. (1989). Disenfranchised grief: Recognizing hidden sorrow. Lexington, MA: Lexington Books.

Evans, C. (2012 July 4) I am the face of stillbirth. Faces of Loss, Faces of Hope. Retrieved from http://facesofloss.com/2012/07/5642.html#more-5642

Evans, C. (2012 July 2) Let's End the Silence! Caleb's Story. Retrieved from http://calebs-story.blogspot.ca/2012/07/uhhhhawkward-silence.html

Gaudet, C. (2010). Pregnancy after perinatal loss: association of grief, anxiety and attachment. Journal of Reproductive and Infant Psychology, 28, 3, 240-251.

Glover, V., Bergman, K., & O’Connor, T.G. (2008). The effects of maternal stress, anxiety, and depression during pregnancy on the neurodevelopment of the child. In S.D. Stone & A.E. Menken (Eds.), Perinatal and postpartum mood disorders: Perspectives and treatment guide for the health care practitioner. New York, NY: Springer.

Goodman, S.H., Rouse, M.H., Long, Q., Ji, S., & Brand, S.R. (2011). Deconstructing antenatal depression: What is it that matters for neonatal behavioral functioning? Infant Mental Health Journal, 32, 3, 339-361.

Gorer, G., & Rickman, J. (1949). The people of great russia: a psychological study. Cressett Press, New York.

Hart, S., Field, T., & Roitfarb, M. (1999). Depressed mothers’ assessments of their neonates’ behaviors. Infant Mental Health Journal, 20, 2, 200–210.

Johnson, C. (2010). Impact of kangaroo care (skin-to-skin contact) on attachment formation between preterm infants and their caregiver. Pediatrics CATs. Paper 9.

JulyBaby (2011, October 8). Stunted grief? Dailystrength.org. Retrieved from http://www.dailystrength.org/groups/mothers-to-babies-after-losing-a-baby/discussions/messages/12988052

Kalaba, E. (2011). Healing through cloth: One stitch at a time. In Dawkins, N. (ed.), HEIR/LOOMS, exhibition catalogue. Montreal, QC: Studio Beluga.

Knill, P.J., Levine, E.G., Levine, S.K. (2005). Principles and practices of expressive arts therapy: Towards a therapeutic aesthetics. London, UK: Jessica Kingsley.

Leif, K. (2012, June 13). (Untitled). Defiling Photos of Dead Babies is NOT ART!, Retrieved from http://www.facebook.com/groups/231476363637900/

Lin, S., & Lasker, J. (1996). Patterns of grief after perinatal loss. American Journal of
Orthopsychiatry, 66, 262–271.

LRusso (2012, May 11). Time magazine cover. Dailystrength.org. Retrieved from http://www.dailystrength.org/groups/mothers-to-babies-after-losing-a-baby/discussions/messages/14250224
Lundy, B., Jones, N.A., Field, T., Pietro, P., Nearing, G., Davalos, M., et al. (1999). Prenatal depression effects on neonates. Infant Behavior & Development, 22, 119–129.

O’Leary, J. (2004). Grief and its impact on prenatal attachment in the subsequent pregnancy.
Archives of Women’s Mental Health, 7, 7–18.

Rando, T.A. (1984). Grief, dying and death: Clinical interventions for caregivers. Champaign, IL: Research Press.

Rando, T.A. (1993). Treatment of complicated mourning. Champaign, IL: Research Press.

Taubman-Ben-Ari, O., & Katz-Ben-Ami, L. (2008). Death awareness, maternal separation anxiety and attachment style among first-time mothers – A terror management perspective. Death Studies, 32, 737-756.

Tess32 (2011, July 2). Natural birth after stillbirth. Babycentre.com. Retrieved from http://community.babycentre.co.uk/post/a12020825/natural_birth_after_stillbirth

Theut, S., Zaslow, M., Rabinovich, B., Bartko, J., & Morihisa, J. (1990). Resolution of
parental bereavement after a perinatal loss. Journal of American Academy of Child &
Adolescent Psychiatry, 27, 3, 289–292.

Westbrook, M. T. (1978). Analyzing affective responses to past events: Women’s
reactions to a childbearing year. Journal of Clinical Psychology, 34, 967–971.

Winnicott, D.W. 1957. Playing and Reality. Harmondsworth: Penguin

Wolff, J.R., Neilson, P.E., & Schiller, P. (1970). The emotional reaction to a stillbirth. American Journal of Obstetrics and Gynecology, 108, 73-77.

Yalom, I.D. & Leszcz, M. (2005). The theory and practice of group psychotherapy. Fifth ed. New York, NY: Basic Books.

Zuckerman, B., Bauchner, H., Parker, S., & Cabral, H. (1990). Maternal depressive symptoms during pregnancy, and newborn irritability. Journal of Developmental & Behavioral Pediatrics, 11, 4, 190– 194.

1Throughout this paper, the term 'child' is used to refer to foetuses, infants, and small children. This usage is not intended to make a political statement on the beginning of life or the value of reproductive choices; it simply reflects the expression of women participating in online forums through which much of the research for this paper was conducted.

2The willingness to respect the boundaries of group members, however, is not universal. It recently came to light that a visual artist in Louisiana had downloaded and edited pictures of stillborn infants with words such as 'sexy' and 'best friends!' for her piece, 'Stillborn in th3 USA'. Though she had taken images from publicly available sources, as most online images are easily downloadable for the use of anyone who wishes to – the news was reacted to with outrage, calls to news stations, and the eventual hacking of her site such that it could not display her work. The level of rage directed at this artist and her piece corresponds with the level of support offered to women who have suffered loss.

Goat Cheese and Roasted Beet Salad

A couple weeks ago we were invited to a potluck-family-get-together-reunion-thing. I love potlucks- but I hate cooking for them.  Not because it requires cooking -I've always loved cooking and food.  I love these elements because they bring people together regardless of language, age, beliefs, etc.  Also, for me food is akin to art. What you create can reflect many things about you. But potlucks? That opens you up to a whole new dimension of pressure.

So as we were going over ideas of what we might bring when my husband ever so innocently suggested we bring coleslaw - I had to kindly (with minimal scoffing) shut him down. "What? Coleslaw? I have standards!" Besides, amongst 40 people you know that the potato salad, macaroni salad and coleslaw will most likely be covered by other people. I couldn't bring coleslaw, it was a matter of pride. No, for this event we needed something different and unique but not too out there that no one would want to try it (as I previously discovered most people have a comfort food zone and things like, say, vegetarian chickpea curry dip rest on the outer limits of this boundary).

After much humming and ha-ing we decided on a salad, since it was a BBQ type affair. After looking through different salads finally decided on a version of FoodNetwork chef Giada De Laurentiis' Beet and Goat Cheese Arugula Salad.

I pretty much followed the recipe (which is a rarity for me), the minor exception I made was that I made a balsamic reduction rather than just whisking together the ingredients for the dressing. Which turned out fabulous because it both thickened and sweetened the dressing adding more flavour and a warmth that just can't be topped when combined with anything goat cheese. Mmm I love goat cheese....

What I especially like about this recipe is that it adds the right amount of healthy with just a touch of naughty to satiate ones taste for indulgence.

Now enough small talk - on to the recipe!

You will need:

For Dressing:


  • 1/4 cup balsamic vinegar
  • 3 tablespoons shallots, thinly slice
  • 1 tablespoon honey
  • 1/3 cup extra-virgin olive oil
Salad Ingredients:
  • 6 medium beets, cooked and quartered (get a pair of nitrile gloves for this step)
  • 6 cups fresh arugula
  • 1/2 cup walnuts, toasted, coarsely chopped 
  • 1/4 cup dried cranberries or dried cherries
  • 1/2 avocado, peeled, pitted, and cubed
  • 3 ounces unripened goat cheese, coarsely crumbled



First and foremost (and the longest part of this entire she-bang) is the beets. Select the ones you want to cook - I made the entire bag and jarred the remaining ones. Put them in a pot (skins on) with just enough water to cover them. Bring to a boil and cook for about 45 minutes- they should be tender enough to poke a fork through.



What most recipes don't tell you is that beets are messy business. Once you have cooked your beets, strain out the water and keep them in the strainer in the sink. This is where your gloves come in. To avoid looking like you have partaken in a crime scene, use the gloves to peel off the outer skins of the beets. With a little cold water they should just slide off easily. Be careful not to get the beet juice anywhere because it stains - and if your house is like mine (built in the 80's with horrid kitchen/decor choices) it will never come out of your white - yes white- counters.

Once you have them peeled cut them and set them aside to cool further. In the meantime start the dressing.


Balsamic reduction is just a fancy way of saying heat up your balsamic vinegar and simmer until it reduces, thickening as it does so. Once this happens whisk in the oil, honey, shallots and cumin.

Once finished put cooked beets and enough dressing to coat the beets in a bowl and toss to coat. Lay beets on a cooking sheet and toss them in a preheated oven (375 degrees). Let caramelize in the oven for about 20 minutes.

While the beets are cooking, toss together the diced avocado, arugula, walnuts and cranberries in a bowl.


Once the beets are done caramelizing, remove from oven and let cool. Once cooled toss them into the salad. Add the dressing and crumble the goat cheese over top of the whole affair and you get this:

Awesomeness in a bowl aka a big bowl of awesome

The original recipe serves 4. However I doubled this recipe for use as a potluck item and the increase in ingredient quantities did not change the fabulousness of the recipe. 

Also, generally when there is a dressing and foliage involved its best to wait until right before serving to put the dressing on. I can tell you that I was in a pinch and went ahead and put the dressing on before leaving my house. 3 hours later the salad was un-wilted and still tasted great. In fact it was a hit at the party!