Deputy Child

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

S. made a request to form boundaries in relations with his parents, who want to control the life of the young family (the case is told with the consent of the client).

S. is a young man, 27 years old, married, defines himself as bisexual. He has an older sister. In conversations, it turned out that S., as a little boy, often heard from his mother words of regret that he was not a girl, that she really wanted to see her son soft, obedient, non-aggressive, caring, so that he would not fight with his sister, but amicably played.

When S. got older, he saw in some medical records (perhaps it was an outpatient card) that he was born from a third pregnancy, that there was still a child between his sister and him. In a confidential conversation with his sister, he learned that a girl was to be born in front of him, who was very much awaited, was already called by name. She died at 39 weeks, almost before giving birth. And a year after the loss, in the same month, S. was born."

Fortunately or unfortunately, this was the only time in my work where a person saw a clear relationship between that loss and their difficulties in adulthood. However, I dare to suggest that the life of substitute children is full of the hidden pain of living someone else's life. Perhaps a person may not even guess that he is living someone else's life, explaining, for example, the choice of an uninteresting professional path for himself by the choice of his parents.

The loss of a desired child during pregnancy is a tragedy in a woman's life.

We noted in the previous article that, finding herself alone with her grief, experiencing the devaluating attitude of the majority, experiencing a great desire to give birth to a child, often a woman tries to erase a terrible event from memory, try to forget and be distracted, start a “new life”, divide it into a period “before and after . This attitude to the situation leads to negative changes in the psychological, psychophysical, emotional states. And this can affect the entire life of a child born soon after the loss.

We will talk about how a woman can help herself with grief and why it is worth postponing planning a new pregnancy.

Work grief and PTSD

As a result of the loss of a child, a “work of grief” begins, the purpose of which is to survive the event, gain independence from it, make it a part of our experience, and adapt to a new reality. If a woman mourned her loss as much as she needed, recognition and acceptance of the loss occurred, the mental pain subsided, an adequate attitude to the event appeared, then the likelihood of any complications of the psychological or somatic state is minimal.

However, there is a possibility that the “work of grief” will not take place in full due to the specific attitude towards reproductive loss in society, including on the part of loved ones who do not know how to support in such a situation. Tears that have not been cried and swallowed will get stuck with a painful lump in the throat, pain behind the breastbone, when a woman tries to "live from a new leaf, and forget everything like a bad dream."

The event that occurs during the loss of a child is called psychological trauma in psychology. And the whole set of experiences associated with a traumatic event is called post-traumatic stress disorder (PTSD). If for some reason the “work of grief” is blocked, especially in the case of repeated loss of a child, then the likelihood of developing PTSD is very high. The degree of its manifestations depends on the peculiarities of the nervous system, the characterological and personal characteristics of the woman herself, the situation in the family, the mood and attitudes of others.

Both grief work and PTSD manifestations have similar manifestations:

- obsessive thoughts about the event, strong feelings of guilt, shame, injustice, resentment, disappointment, anger, envy, helplessness;

- decreased mood, inhibition of movements and mental actions, decreased memory and attention, sleep disturbance, avoidance of situations associated with loss.

However, gradually, as you grieve, the psycho-emotional state gradually levels out, whereas in the case of PTSD, all these conditions acquire a chronic form with successive improvements and deterioration of the state.

With PTSD, it comes to the fore that with active denial and avoidance of memories of loss, people who know about the situation, conversations or places that could remind, there is an obsessive replay in the mind of the events of those days, especially if something arises, which may somehow be associated with loss. For example, the smell of a hospital, some kind of medical equipment, a typical weather phenomenon of that day, some kind of music, a meeting with pregnant women, a baby, his crying, and so on - the so-called trigger that instantly triggers memories.

The manifestation of PTSD can also include a hypertrophied feeling of guilt, fear, sometimes reaching the level of horror, to face loss during pregnancy, decreased immunity, the appearance or exacerbation of some somatic diseases, sleep disturbances, nightmares. There is an assumption that the emergence of the threat of termination of the next pregnancy, provided that there are no objective reasons for the reproductive system, is due to the phenomena of PTSD.

As a result, if the loss of a child for a woman turned out to be a personally significant tragedy, then not allowing oneself to adequately respond to this situation, to launch the “work of grief”, can result in the development of post-traumatic stress disorder, the consequences of which can be unpredictable.

The four tasks of living grief

The first task of the work of grief - This is the recognition of the fact of loss. No matter how hard it is, you need to face the truth: this long-awaited baby, son or daughter, has died, this is forever, that this loss is irreplaceable. Now you have to live with this experience of loss all your life.

Here, there are three main complicated reactions that can block the work of grief from the very beginning - this is a denial of this fact, a denial of significance and a denial of the irreversibility of loss.

Denial of fact - if all objective studies - analyzes, ultrasound, examination, listening - everything indicates that the child died, or even an operation was performed, but still there is a hope that he is alive, that they looked badly, that there is a medical error. Or that during the operation he was not noticed, if it is a short time, and left in the uterus, that he survived by some miracle, or that there were twins, and one of them survived, which may be accompanied by a search for appropriate sensations during pregnancy, toxicosis.

Denial of significance It is the most common type of complicated reproductive loss grief and is the most common cause of PTSD symptoms. An attempt to convince oneself that “there is not a person yet”, “this is a clot of cells, an embryo, an embryo, a fetus”, with a widespread similar attitude of others - both in a medical institution on the part of senior and junior staff, and on the part of relatives and friends.

Denial of irreversibility of loss expressed rather on a transcendental level. A person who has religious pluralism in his worldview, or is under the influence of "magical thinking" under the influence of severe stress, wants to find solace in the thought that the child's soul stays close and "will be reborn" or "come back" during the next pregnancy. A believing Christian knows that during conception a unique person arises, a person who has not only a body, but also a soul and spirit. The soul is not originally created, it cannot move from body to body. And at the time of physical death, a person gains eternal life, appears before the Lord for his judgment. Saint Theophan the Recluse gave the following answer about the fate of children who died unbaptized: “All children are angels of God. The unbaptized, like everyone outside the faith of those who exist, must be given the mercy of God. They are not stepchildren or stepdaughters of God. Therefore, He knows what and how to establish in relation to them. The ways of God are abyss. Such questions should be resolved if it was our duty to look after everyone and attach them. As it is impossible for us, then let us take care of them to the One who cares for everyone."

The second task of grief Is the experience of all the complex feelings that accompany loss. The death of a child should be mourned as much as is necessary for the mother. A special place at this time is occupied by internal work with a sense of guilt, because in a situation of losing a child during pregnancy, it may seem that the woman is to blame for everything, that she “did not save”, as if the issues of life and death are in her power.

An important step is clarifying the situation and separating real and perceived guilt. In most cases, no one is to blame for the death of a child, because death occurs due to a disease incompatible with life.

The second important step is to clarify and assign responsibility for the event. It is very difficult to carry the entire burden of responsibility for the loss on your shoulders. The deceased child has a father, there are other relatives, there is a medical staff, a doctor who led the pregnancy, and in whose competence were certain decisions. To reduce the severity of the mother's feelings of guilt, it is necessary to share responsibility with all those involved in those sad events.

It is important to get support in the process of experiencing the feelings that accompany the loss. If there are no understanding people around, you can turn to virtual support groups on social networks. Grieving parents gather there, share their stories, help each other, understand each other. Often these groups have psychologists who are ready to provide professional support if necessary. This can be very helpful.

At this stage, complicated reactions can be denial of sorrowful feelings, their devaluation, and ignoring. Blocked or unexpressed feelings can go into psychosomatic diseases or behavioral disorders, depending on the virtual reality.

Even in the hospital, a woman can hear from the medical staff that she “shouldn't cry, stop crying, she should pull herself together, not become limp,” “why are you crying, you have a child,” “he was still dead, you know, it was necessary". Relatives and friends are also not always ready to meet with strong feelings, blocking the conditions for support immediately, or after a short period of time after the loss: "stop killing yourself, smile, come on, put yourself in order, life does not end there."

The third task of grief - this is reconciliation with a new state, a new organization of space and environment.

It happens that a woman finds out about pregnancy at the time of her loss. But more often it happens that some time passes before the loss, when parents have time to rejoice at the news, start preparing for the birth of a baby, purchase a dowry, prepare a room. There may be some agreements related to the expectation of birth. All this will need to be replayed.

It is not about getting rid of all the things that remind you of the dead baby. But keeping them in plain sight in the hope that they may still be useful is like constantly rearing a wound. You still need to prepare for a new pregnancy, add nine months to this. It turns out that there is a lot of time ahead - in the meantime, things can be put away for storage, or given to friends for temporary use, with a return. If the nursery was already ready for the child and after a long time after the loss, this room is not used in any way, this may turn out to be an alarming signal for the development of pathological grief, rejection of the situation, the formation of an overvalued idea of having a child, where the help of a psychiatrist may be needed.

The fourth task of grief - this is the time when the child takes its place in the heart of the parents and in the entire family system.

The implementation of this process can be clearly seen on the image of the family tree. If you depict a husband and wife, then the images of their children will depart from them with lines. And the deceased child must take its place in these schemes. If he was the very first, then the next child will already be the second. If he was the third or fifth, then the next child will already be the fourth or sixth. This, of course, does not mean that when asked by strangers about the number of children, all born and unborn children need to be voiced, but this memory is important for the family itself, for the history of the clan. This means that the child was, was adopted by his family, but lived only a few weeks, that he has a meaning and value in the life of his parents, that he is remembered and prayed for.

And it is at the end of the last task of grief that further pregnancy planning is possible. … So we come to the answer to the question, why shouldn't you do this earlier?

Planning a new pregnancy

Gynecologists say that it is necessary to plan a new pregnancy no earlier than 6 months after the loss. Good gynecologists say that you need to wait about a year - this is how much time the body needs to recover at the biochemical and hormonal levels. During this year, you can try to find out the cause of the death of the child, make the necessary research, perhaps some kind of treatment, how to rest.

Even if the body is ready for bearing within 3-6 months after the loss, then grief blocked at some stage can manifest itself in psychological problems with conception, in the psychological reasons for the threat of interruption, and in the development of an attitude towards the child as a substitute for the deceased.

And here the motivation for having children comes to the fore. In a family where the spouses do not "want children", but simply love each other, accepting each child as an extension of their love, perceiving each child as a unique person, the one and only, the attitude towards the loss of a child may differ from a situation where the leading motive there was a desire to “have / have a child”, as “biological clock”, “everyone gives birth, and I have to go”, “so that my little brother was not bored”, “for a glass of water in old age”, so that “there was a big family and it was fun”, “So that I have someone to take care of”, “to find meaning”, “to strengthen the marriage” and so on. Even at the stage of planning pregnancy, it is important for a woman to answer the questions: “Why do I want to be a mother? Am I ready to be a mom? what does motherhood give me?"

Any other motive, except for the birth of children as a continuation of the love of their parents, can turn into a serious disappointment in life, because the child must live his life, and not meet the expectations of his parents.

There are basically two motivations for having children that lead to unmourned grief and PTSD.

"Give birth at any cost, just to give birth" - when all interests, all means of the family, all resources revolve around the implementation of this. The desire to give birth to a child becomes an overvalued idea, in order to prove to myself and everyone that “I can”. In psychology, this is called "shift of motive to goal."

As an example (history and details have been changed): “after the first loss in a short period of time, several years of unsuccessful attempts at conception, a married couple applies for an IVF service. Before the successful birth of a child, there are 3 losses - one in the first trimester, two in the second. After the birth of the child, it turned out that his parents, overwhelmed by a passionate desire for his birth, are no longer interested in each other as spouses. Now the child is being raised only by the mother."

"Give birth as quickly as possible to replace the lost" - when the work of grief is blocked or depreciated even at the stage of accepting the fact of loss, then, accordingly, there is no acceptance that the child was and died, that he took his place in the family system, no, they did not say goodbye to him. More precisely, he takes his place, but this place is denied in the minds of parents, on the one hand, and on the other, there is some idealization of the unborn child, that "he was probably very smart, talented and beautiful." Great hopes are pinned on a child who is born after a loss - he was very much expected, he will be very patronized, he will “have all the best”, but at the same time he will have to bear the whole burden of comparison with the one who came before him.

Just imagine what it is like not to be yourself, living your own life, but to seem like someone else, trying to live up to expectations, but still be different. Especially if there is a conviction that "it was his soul returned."

This situation is described in the story at the beginning of the article - a year after the loss of his daughter, a son was born in the family, from whom it was expected that he would replace the lost daughter.

Summarize:

1. Loss of a child is a tragedy in a woman's life that needs to be accepted, mourned, experienced, reworked, said goodbye and created her place in the family system as a unique, significant, important, family member who has lived so little.

2. The work of grief is not determined by the time frame, but by the realization of the tasks of mourning. Blocking grief from working at some point can lead to the development of a serious condition called post-traumatic stress disorder.

3. The development of PTSD interferes with psychological recovery, significantly affecting the quality of life of a woman and her family.

4. The development of PTSD affects the emergence of destructive motivation for the birth of children after loss, which results in serious intrapersonal conflicts in the child, which can significantly affect the quality of his life not only in childhood, but also in the future.

5. Therefore, it is very important for a woman to take care of herself, to find a source of support that will help the work of grief - maybe it is a relative, a friend, a support group in a social network, or professional psychological help.