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Shattered expectations and trauma: coping and processing

Many parents whose babies are born prematurely were not expecting it and do not have a great deal of time to process and accept what happens. Guest author Dr Jenna Brough discusses how to cope with shattered expectations and trauma.

Editor’s note: It’s my pleasure to welcome Dr Jenna Brough BSc, DClinPsy, DipHb(KGH) to PremDad. This post is a must-read for parents who are currently going through, or have recently experienced, life in the neonatal unit. Over to Dr Brough!

As a Clinical Psychologist much of my work is about supporting people who are struggling after traumatic experiences, dealing with difficult emotions and the impact this is having on them, their relationships, and their lives.

Many parents whose babies are born prematurely and require NICU support, were not expecting it, they do not have a great deal of time to process and accept the changes from their expected pregnancy, birth and new-born experience…

Dr Jenna Brough

A baby shower with all your close friends and family getting excited with you, starting maternity leave, packing your hospital bag and repacking it ten times over, the birth itself, the cutest outfit you bought to bring baby home in. Not many NICU parents have the advantage of knowing these will be missed, completely different to how they envisaged, too big for weeks if not months….

And yes, I say knowing your baby is going to be born prematurely and be in NICU is an advantage, because it gives you time to process and adjust…. to be mentally prepared somewhat (even if the reality is quite something else to what you imagined would happen).

The impact of a NICU stay

Psychologically speaking there are two main issues that may impact the emotional well-being of NICU parents… One is shattered expectations, and the other is trauma.

You may hear shattered expectations also being referred to as grief… the adjustment process is akin to grieving for the experiences you expected but never got.

And being mentally unprepared for the experience, puts you at greater risk of being traumatised by it. Though those parents who expected a premature birth and NICU stay can also be traumatised by the experience itself. And as those of you reading this will know better than me, the NICU experience is something no-one can really be fully prepared for.

“A traumatic event is one that someone perceives as physically or emotionally threatening or harmful, to themselves or their loved ones”

Signs of trauma and how to overcome them

So you weren’t expecting it or you didn’t have time or headspace to adjust, you’ve been through it, and now you’re struggling….

  • Experiencing a lack of emotion/numbness?
  • Feeling on-edge, on high alert and unable to relax?
  • Fluctuating between the two?

These ‘symptoms’ will often see you attract a label of depression and/or anxiety from your GP/primary care mental health practitioner. But it is better understood as difficulty coping with your shattered expectations and/or the traumatic events you have experienced. Shutting down or being hypervigilant are understandable coping mechanisms – your mind is trying to protect you from possible threats*, but these mechanisms are obviously unhelpful!

*in the case of PTSD the memories of the event/s resurface because they haven’t been properly processed, this tricks your brain into thinking you are currently under threat…

So, what can you do about it…. whilst it depends where you are on your journey when you are reading this, here is some general advice….

  • Acknowledge what has happened and that you are human – you have been through a traumatic experience with little/no time to mentally prepare yourself… you have invariably pushed down your own needs and struggles to be there for your baby, ‘get on with it’, and survive (now in the aftermath it makes sense that your emotions have resurfaced, and you are struggling).
  • Talk – everyone asks how the baby is, rarely how the birther is, and almost never how the partner is …. adjusting to and processing your experiences will be unlikely to happen if you suppress what you are thinking and how you are feeling…. Talk to your partner, a close friend, a fellow NICU parent (lovely social media communities), or a mental health professional (more on that later).
  • Let yourself feel – as well as talking about your thoughts and feelings, allow yourself to sit with them and feel them. Emotional expression is healthy and to quote a well-known phrase “it’s okay to have a meltdown, just don’t unpack and live there”. Some people fear that they will lose control if they let their emotions out…. but the mental effort it is taking to keep it together will lead to a bigger break in the long run… release the pressure you will feel better for it!

Whilst the above advice is general and aimed as relatively pro-active self-care, I do want to advise regarding seeking professional support….

  • Some hospitals have counsellors, psychologists and additionally trained midwives/nurses attached to their NICU departments – and you may be reading this having been afforded that support and feeling no long-term negative effects of your experiences. If your baby is still in NICU you may be able to access one of these services… ask at the hospital.

If you were/are not in this position and you identify with some of the difficulties I have touched upon, you may wonder whether you should, and how you could, seek professional support?

If talking to others has not helped, you are feeling the same or worse over time, and/or you are not engaging with everyday activities because of how you feel/are coping, it would be a good idea to speak with a professional…

  • Though not strictly specific to NICU journeys, Perinatal Mental Health teams in the NHS offer support for parents in the first year of their babies’ life. Service provision differs between NHS trusts, but you can check this out with your health visitor or on your local NHS trust website.
  • Alternatively, you may be in a position to seek private (self-funded or funded through health care insurance) psychological support. There are many mental health professionals (and others) who offer support in various forms. Please check the credentials and experience of the practitioner/professional you are looking into receiving support from. There are now many private practitioners, describing themselves as postnatal well-being coaches or birth trauma practitioners for example, who have no core professional background in mental health.

As a qualified, registered, and insured Clinical Psychologist I offer individualised psychological therapy in relation to fertility, pregnancy, loss and post-natal well-being for individuals and couples. I am also a trained KG Hypnobirthing teacher and offer hypnobirthing and antenatal preparation group and private courses. You can find me on Instagram and Facebook @tribepsychology or email tribepsychology@outlook.com

Useful website links/organisations:

About the author

Dr Jenna Brough BSc, DClinPsy, DipHb(KGH) is a HCPC registered Clinical Psychologist with 12 years experience working to support the emotional and psychological well-being of children and adults across NHS, private, and charitable organisations in England. For over three years Jenna has been working as a Senior Lecturer in Clinical Psychology at the University of Lincoln. In April 2020 Jenna qualified as a Hypnobirthing Teacher following completion of the Royal College of Midwives accredited KGHypnobirthing training programme.

By Dr Jenna Brough - DClinPsy, DipHb (KGH)

Dr Jenna Brough BSc, DClinPsy, DipHb(KGH) is a HCPC registered Clinical Psychologist with 12 years experience working to support the emotional and psychological well-being of children and adults across NHS, private, and charitable organisations in England. For over three years Jenna has been working as a Senior Lecturer in Clinical Psychology at the University of Lincoln. In April 2020 Jenna qualified as a Hypnobirthing Teacher following completion of the Royal College of Midwives accredited KGHypnobirthing training programme.

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