Many of us will be sitting around a table with family members tomorrow. And for many of us, this can a stressful and triggering event. Family members may have differing views or opinions than you. Maybe they make a comment on how much food is on your plate or the weight you’ve gained this past year. Perhaps you are at the table with your partner and your family has something to say about why you’re not married or have children. No matter what the comment may be, sitting in forced proximity to toxic family members can be a mine field of triggers. So how do we navigate this? 

First it is important to know your triggers. Be choosy when it comes to the activities, engagements or conversations that may bring forth painful memories or can drain you. It is ok to walk away from a person or a conversation that can potentially push you over the edge. 

Second, be wary of the level of engagement you give people who deplete your energy. Not every comment or look calls for a verbal response. It can feel good in the moment to fire back a spicy retort, but this can further drain you and cause an escalation in conflict. Simply walking away and not taking the bait can speak volumes itself. 

Third, prepare your responses ahead of time. If a comment does warrant a verbal reaction, have on deck a handful of responses that can shut the conversation down without giving into someone’s negativity. “That’s not up for discussion” or “I’m sorry you don’t like my choice but I stand by it” and a time old favorite, “If you continue to bring this up, I will not participate in the conversation”. 

Fourth, have an exit strategy. I love to suggest to clients who arrive at triggering events with a partner to have a safe word chosen beforehand. If things get out of hand or your nerves are frayed, having an agreed upon safe word or exit strategy with your partner can help you get out of there quickly and safely. If you’re there on your own, even easier. Have an excuse in your mind ahead of time to help you get out of a situation that is not serving your mental health. Do not push yourself to stay in a situation longer than you can stand to please others.

Fifth and finally, be sure to spend time with those that love, support, encourage and fulfill you. Family is not just blood relatives but the family that you’ve created. Choosing your found family over blood family is not something to feel badly for. Do not spend your time with those who drain you but those who fill your cup. 

This holiday season remember that it is ok to say “no” to situations or family parties that bring you no joy or peace. It is ok to choose to surround yourself with loving energy of those who care for you. Your mental and emotional health deserves to be cared for even during the holidays. 

Ambiguous grief is a concept that I had not been familiar with until a client I had was telling me about her relationship with her estranged daughter. She stated to me “I feel like I’m mourning, but she’s still alive”. So I did some digging and was amazed to find that this was indeed a theory that was already recognized.  Ambiguous grief (or ambiguous loss) at it’s core, is all about the lack of a resolution. When we lose someone to disease or a tragic accident, we go through the process of saying goodbye to this person. We process their death and go through the ceremonial processes of remembering them and their life. But when someone we love and had in our life becomes estranged to us, there is no closure. Closure is an important part of our grief process. It provides us with a way to process what has happened.

There are two categories of ambiguous loss. Type-one ambiguous loss occurs when there is a physical loss. This is where a loved one goes missing, where there is a physical absence with a psychological presence. When someone you love is physically absent under unknown circumstances (i.e. deportation, natural disaster, or kidnapping). It can also come in the form of a loss of contact. These circumstances can include, divorce or estrangement. The person was who was once in our life and is now gone, leaving you without answers.

Type-two ambiguous loss explains a mental or emotional disappearance. When someone’s personality has changed to a point where they no longer look like a person you once knew. Your loved once is present but they’ve changed emotionally or cognitively (sometimes both). Some examples of type-two ambiguous grief can be, Alzheimer’s disease, traumatic brain injury, addiction, or mental illness.

Ambiguous loss can be especially difficult and terrifying. But there are ways to cope with this type of loss and grief. The stages of grief will look differently than traditional stages of grief.

1.       Name What You’re Going Through- this can be a tough feeling to name. But now that you have a way to describe what you’re experiencing, put a label on it so you can begin the healing process.   

2.       Work Towards Acceptance- this will not be the same as closure. When we are not able to find closure through ambiguous grief, acceptance can help you to make peace with the new reality.

3.       Reach out for Support- find a family member, friend, or someone who has gone through something similar. It can be surprising to find that many people can be experiencing similar things to you.

4.       Look for Silver Linings- this is not the same concept of toxic positivity (something we’ll explore at a later post). Instead of looking for the silver linings, look for what has come your way. New friendships, new causes, new chances for personal growth.

5.       Be Kind to Yourself- give yourself grace and compassion as you work through your grief. These are challenging emotions and no timeline to work through them. Give yourself the space and time to do so.

Ambiguous grief or loss is a challenging and tricky road to travel down. Remember to reach out to a therapist who specializes in grief that can help you through the loss.

What Ambiguous Loss Is and How To Deal With It. (2022, February 17). Cleveland Clinic. Retrieved May 23, 2022, from https://health.clevelandclinic.org/ambiguous-loss-and-grief/ 

April is c-section awareness month and during the month of April, Thrive Postpartum and Couples Therapy will be featuring Mamas who have experienced a c-section birth(s). One amazing thing that has been learned through the interviewing process is how different each circumstance is that led to a c-section birth. No matter how your baby was brought into this world, your experience is valid and important. We would like to feature Mamas who have experienced a c-section as many times these experiences are looked over. Discussing c-section experiences can still feel taboo and uncomfortable. But we are hoping to break down barriers and allow for a safe space for these important stories to be told

This is Melissa’s story.

1. Please share the circumstances that led to your c-section birth(s). 

My whole pregnancy I felt “off”. I had a lot of sickness and pain and was quite miserable. In the 3rd trimester, my symptoms changed to rapid weight gain and severe swelling. At 35 weeks, at the urging of some coworkers, I called my OB went in. I was diagnosed with pre-eclampsia. For the next 3 days I was in and out of the hospital until I was diagnosed with severe pre-eclampsia and they decided to induce me. I wasn’t induced long before they became concerned about my increased upper right quadrant (URQ) pain and decided it was time for an emergency C-section. 

2. What surprised you the most about having a c-section? 

Having an emergency C-section left me surprised, bewildered, scared, and feeling helpless. I was most surprised with how quickly things progressed from being induced to being cut open. I didn’t have much of a chance to be in labor. I felt so much URQ pain that I didn’t feel the pain of my contractions. As odd as it may sound, I felt the experience of labor was robbed of me. There was no comfort in the room. It was sterile and everyone was prepared to save my life and the life of my baby, not make sure I was comforted. I remember calling out that I needed to throw up multiple times and finally the anesthesiologist answered and told me “just turn your head.” My husband was in the room, luckily, but I was so out of it, I don’t remember much. My birth story is traumatic, fuzzy, and full of medical interventions. After birth, I was diagnosed with Pulmonary Hypertension and HELLP syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelets), which is a rare and life threatening complication of pregnancy. 

3. What kind of support do you feel you received (from friends, family, healthcare team) after your c-section(s)?

Unfortunately I don’t feel like I received the support I needed from my healthcare team throughout my pregnancy and birth. I had some supportive nurses, which was helpful. Everything was so rushed, as I’m sure it needed to be to save my life. Even after birth I had to advocate for myself to get scans that I felt I needed. My husband was incredibly supportive. But I sent him to the NICU in a hospital an hour away to stay with our daughter as I was separated from her. My mom stayed with me the 4 days in the hospital. After 4 days I was released with no explanation, no resources, no support, just some follow up doctors visits, BP meds, and to return if my BP was over 140/90. 

After my experience, I joined Facebook support groups for survivors of pre-eclampsia, eclampsia, and HELLP syndrome. I’ve learned so much. I also decided to become certified in perinatal mental health. As a therapist myself I always loved working with general Women’s Mental Health Concerns. But after this experience, I knew I wanted to work in the perinatal/maternal mental health world as well. 

4. What’s your #1 piece of advice/encouragement for a new c-section mom?

This is a very shortened version of my traumatic birth story. A majority of mamas that have C-sections have been through traumatic childbirth. If I could offer any support for a new C-section mom, it would be to let you know that You Are Not Alone. I have been through a lot of therapy to work through my birth trauma experience. My advice is to seek out a perinatal mental health certified therapist that is trauma-informed to work through your experience. Even if you feel you weren’t traumatized by your experience, it can be incredibly helpful to work through the grief that ensues with a birth that does not go according to plan. I am grateful for the ability to get to the point where I know my body didn’t fail me, it saved me and my baby. An emergency C-section is a part of that story.