We have talked to the psychologist Paz Ferrer Ispizua, a duel specialist in addition to doula, on how to identify the moment in which a mother who has suffered an abortion may need psychological therapy. Today we publish the second part of this interview, in which we deepen a little more about the emotional dimension of natural abortion, post abortion psychological therapy and the grieving process that this vital crisis Make necessary.
Does our society deny the pain of natural abortion or minimize it?
Our society fears pain and minimizes it, banalizes it or makes it disappear. Death is a taboo, and the death of an unborn baby, precisely because it is less visible, is easier to deny or blur. Our fear, as an advanced and technological society, is an expression of what we cannot control yet, which is death.
Is the grieving process different in the case of natural abortion?
All grieving processes, even those of the same person, are different from each other. However, in general, in a natural abortion there is usually more sense of uncontrollability, of "not serving to gestate", of having done something wrong or counterproductive without knowing it, and feeling guilty about it.
Probably the lack of control, the helplessness of the inevitable, the helplessness, the most characteristic aspects of this type of abortion, but each case is different.
What fears are normal and when do they begin to be pathological?
All fears are normal, that they are "pathological" is a matter of degree. It is not so much what is fear, but what happens to him: if that fear dominates the person's life, if he invalidates it to continue, if he does not let the wound close, it begins to be pathological. "Pathos" originally means "pain." There is a pain that is normal, that is "healthy", that is healing, and there is a pain that prevents us from living, that burdens us, that does not let us move or continue. This is the pathological pain.
What are the most common fears of women who suffer a miscarriage?
Do not serve to gestate, have "something bad" in your body that prevents it, that the situation is repeated, have done something wrong that caused it, etc. In general, fears that have to do with interpreting a fact that, in general, escapes control as something they "have done" them, as well as to happen again.
Does knowing the cause of abortion help or is it worse?
In general, knowing the causes helps to understand the events, to integrate them, but there are certain situations in which the guilt that can be awakened must be elaborated: for example, if a certain substance has not been taken and the pregnancy has been lost by a malformation, if there are genetic defects in the family, etc. In these cases it is very important to do a job to desculpabilize and learn to forgive and forgive. Knowing the causes allow us to make attributions, and in that sense they can reduce anxiety, but we must be careful that there are no other side effects that are counterproductive.
Does the feeling of guilt influence?
Guilt is the most dangerous emotion, because it is destructive: it does not generate any movement, and it consumes the energy of those who experience it. When a person feels responsible for an event, he can do something to repair it, or he can forgive himself and accept the consequences he cannot repair; When a person feels guilty, he can only feel sorry for himself.
In this sense, learn to delimit how far each person's responsibilities go (mother, father, health personnel, if applicable, etc.), accepting that there will probably be a part that is not the responsibility of anyone, is liberating and healing, and The first step to grow from an experience as painful as this.
What type of therapy would be the most advisable?
Any therapy that allows to close and say goodbye, understanding that that baby who was not born will ALWAYS be part of our life, that existed and that deserves recognition and respect, but that the best way to honor it is to live happily carrying that memory as a treasure. The farewell is not forgetting, because we must not say goodbye to that being, but the pain of having lost it, of the expectations, of the plans. This is only possible if guilt, anger, fear are released, and it must be understood that it can be a slow process and that it will have moments when it seems that it goes back and goes “backwards”, but that this is part of its natural becoming. In this sense, the farewell and tribute rites are important, as well as keeping some memory (an ultrasound, a photo, a hat if the baby came to term, etc.), because that person, even if he was not born, formed and will be part of our life. How this process is technically carried out is not really important, because the main thing is the content, the objective, beyond the form. A different approach can be better for each person (more spiritual, more technical, more experiential), and the most important thing is that you feel comfortable with it, that you really feel comfortable to face the process.
Does a natural abortion remove previous emotional problems or by itself can already cause the need to seek help?
Both things, because it depends on each person, on their personal history. By itself it is an emotionally very intense event, but a person who naturally lives his painful processes, who has learned from his childhood to manage them, could elaborate his experience and integrate it into his life without needing help. On the contrary, a person who has few resources in this regard may need help, be it his first "traumatic" event or one more in his personal history.
Should a woman seeking psychological help to overcome an abortion feel sick or less strong than others?
Seeking help is not being "sick", although in our society this is not yet an extended belief, nor is it a sign of weakness. It implies a global change in the way of thinking, but understanding that we can be vulnerable, that we may not know everything, that we can let ourselves be taken care of is a way of living better, with more tranquility, because we are not “super women”.
We must be stronger to accept our own weakness and recognize that we want support than to swallow the pain and pretend that nothing happens.
What personal circumstances, in your opinion, aggravate the possibility of needing help?
Lacking family and friendly support networks, or that these are of poor quality, may increase the possibility of needing external support.
Is emotional attention appropriate to abortion or perinatal loss in hospitals?
In my opinion, it is not only adequate, but necessary, and should start with an education of professionals who may encounter these events in their daily practice, since many times they and themselves are overwhelmed by them. The first moments are crucial in the subsequent development of the grieving process. In fact, laying a good foundation, most cases do not require further attention and are not complicated. This does not mean that it is not possible to intervene later with success, but the maxim “better prevention” is especially applicable in this case.
And when it comes to a perinatal death or a very advanced pregnancy?
It survives as other experiences survive, that is, that the soil process is basically the same, because it is a "physiological" process. The time of pregnancy is only a particular circumstance that must be taken into account.
In fact, being able to hold in arms, dress or photograph a baby who was born dead or who died shortly thereafter helps to elaborate the duel because it gives that "real" entity to that baby, which is no longer an idea, or a set of shapeless cells.
Give a name to the child and understand it as part of our life, not denying us his loss, helps or increases the pain?
Naming, understanding and integrating a child, born or not, alive or dead, in our life is the ONLY WAY to transcend that event and grow with it, to be able to live with it in a healthy way.
Does the time of loss in pregnancy, earlier or more advanced, influence psychological recovery?
It can influence, but it is not necessarily decisive. My experience does not allow me to make a generalization in this regard, since it depends, once again, on the personal process of elaboration of each person.
Is an abortion forgotten or overcome?
It is neither forgotten nor surpassed, it is INTEGRA. It is not an event to be banished from life, to be cornered, but an event that must be embraced and understood as part of our life experience.
What would be the healthiest way to deal with this vital crisis?
Knowing the process, understanding it, letting yourself feel, learning to ask and be vulnerable, and seeking support and help when needed. There is no other "healthy" way to do it, because it cannot be hidden, or pretended to have not happened.
What does a mother do with that love that she could not give to a child who did not live outside her womb?
From my point of view, to express it: in the love of other people in his life, in the love of himself, in the memory and honoring that son who, although he was not born, allowed him to learn to love so much. Finding a joyful, beautiful way to let out those feelings is not only the best way to honor and recognize that being, but also to grow with this intense experience at all levels.
Love is therapeutic, love is the path not only towards healing, but also towards growth. For a mother who has lost her long-awaited, desired, loved child, it is painful to say goodbye to him and recognize him as a part of his experiences, but it is the way to integrate this experience healthily.
Beautiful and sad condemnation, real and realistic, with which we ended our interview Paz Ferrer Ispizua, psychologist and doula duel specialist, with which we have learned a lot about the process of grieving for a natural abortion, its emotional consequences and the post abortion psychological therapy. I can rarely say with as much sense and feeling as now that I hope that my work helps other mothers.
