tag:blogger.com,1999:blog-8184208181444239184.comments2024-03-14T13:25:42.698-04:00Child in MindClaudia M. Gold, MDhttp://www.blogger.com/profile/13081419560269676730noreply@blogger.comBlogger305125tag:blogger.com,1999:blog-8184208181444239184.post-47084013089708544872018-01-29T10:51:42.063-05:002018-01-29T10:51:42.063-05:00I just finished reading The Deepest Well and despi...I just finished reading The Deepest Well and despite everything I already knew about ACEs found it fresh and inspiring and loved her humor and examples of how she has learned to incorporate ACEs screening and support into her medical practices. <br /><br />I'm a former family doctor who retrained as a somatic psychotherapist and then specialized in trauma therapies. Porges' work, freeze states, understanding attachment & development from these neurobiological perspectives - it all changes how we think of and understand health in such profound and inspiring ways. <br /><br />I've specialized in chronic illness and see it from a similar view point as you and Burke Harris express - an altered physiological state reflecting a nervous system (and hence so many other systems) caught in fight / flight / freeze at the cellular / biological / physiological levels. It brings in so much hope - even as we continue to work with the resistance, shame and blame that it elicits in some. <br /><br />I find this negative reaction to be very strong in the chronic illness community, so many of whom have been told their (often difficult-to-diagnose) symptoms or diseases are psychological or "all in their heads" if there is a history of trauma. <br /><br />Thanks so much for sharing your conversation. I'm thrilled to see that you have a book out on these views of development :-). It's exciting to see this information coming into medical care, even if it is a slow process.Anonymoushttps://www.blogger.com/profile/16912522446654352647noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-90515891560826575912018-01-29T07:29:53.785-05:002018-01-29T07:29:53.785-05:00Yes the Polyvagal theory as described by Dr. Porge...Yes the Polyvagal theory as described by Dr. Porges adds an important dimension to the question of how trauma comes to live in our bodies. It is in alignment with Ed Tronick's Still Face research showing that patterns of relating with primary caregivers become integrated into our relationships but with an emotionally unavailable caregiver, eg a depressed mother with a chronic "still face" these patterns of relating become maladaptive in our social interactions going forward.Claudia M. Gold, MDhttps://www.blogger.com/profile/13081419560269676730noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-60514996075457838772018-01-29T06:47:36.772-05:002018-01-29T06:47:36.772-05:00Vis-à-vis the vagus, I wonder if a "shut down...Vis-à-vis the vagus, I wonder if a "shut down" response can become a chronic response to chronically unresponsive caretakers as a child, which then carries over into adulthood? Unknownhttps://www.blogger.com/profile/14961381731412536747noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-20291348817566323042018-01-27T11:10:05.254-05:002018-01-27T11:10:05.254-05:00Part of the problem here is a sort of catch-22 whi...Part of the problem here is a sort of catch-22 which you noted in your email exchanges with me. Instead of hearing "I recognize your suffering..." parents these days hear "Your kids' problems are all your fault." Pharmaceutical companies are quick jump in and say the problem is entirely within the kids' defective brains.<br /><br />In psychotherapy, the therapist can use empathy to counter the inherent paradox of "you need to parent differently, but you are blameless." In public forums, this is much harder to handle.David M. Allen M.D.https://www.blogger.com/profile/06280912088483192599noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-33907741839189219842017-09-13T13:38:27.085-04:002017-09-13T13:38:27.085-04:00My own area of specialization is as a trauma based...My own area of specialization is as a trauma based therapist for adults with chronic illness, which is a less discussed but increasingly recognized effect of these early and common traumas. It's great to "meet you!"<br /><br />Here too the stigma and feelings of blame are extremely common. <br /><br />Many people with chronic diseases who have a history of trauma have been told by health care professionals that their diseases are (therefore) all in their heads. This old way of thinking has caused similar harm as what you mention and lead to a profound aversion to considering the role of trauma for so many with chronic illnesses. <br /><br />This relates also to what David M Allen mentions above - the risk of believing that if we can do something about healing past trauma as an approach to healing chronic illness it implies blame. <br /><br />Here's to ongoing learning, education and empowering ourselves, our colleagues and those in positions to change the outcomes of their own health and the health of their kids.<br /><br />PS - I just found your post on ACEs Too High and appreciate your references also to Jack Shonkoff and Ed Tronick's work. Thanks for your post!Anonymoushttps://www.blogger.com/profile/16912522446654352647noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-42464965378735129622017-09-08T10:45:35.649-04:002017-09-08T10:45:35.649-04:00It's quite a tightrope walk avoiding sounding ...It's quite a tightrope walk avoiding sounding like you're blaming parents when they are physically or sexually abusing their child, but I agree it is an important consideration in finding ways to put a STOP to it. I like John Rosemond's quote: ""Taking responsibility for something and self-blame are horses of two entirely different colors. The former is empowering; the latter is paralyzing." David M. Allen M.D.https://www.blogger.com/profile/06280912088483192599noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-12428163778895252512016-05-22T20:24:19.350-04:002016-05-22T20:24:19.350-04:00The vast majority of the children and teens who ge...The vast majority of the children and teens who get antidepressants these days for "depression" do not actually meet DSM criteria for major depressive disorder. Clinicians who presribe them, if they say anything about it at all, label the family situation as "WNL." What that really means is not "within normal limits" but "we never looked."David M. Allen M.D.https://www.blogger.com/profile/06280912088483192599noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-68617728024672966632016-03-15T11:26:53.706-04:002016-03-15T11:26:53.706-04:00I recently came across some characters in the Bibl...I recently came across some characters in the Biblical story of Job that I didn't know about known as "Job's Counselors." They told Job that if bad things were happening to him it must be because he was not pious enough - the exact opposite of the truth. Not just psychiatrists but psychologists and social worker therapists as well have become analogous - if you're upset, angry, or unhappy with the way the world is treating you, then therefore there must be something wrong with YOU!David M. Allen M.D.https://www.blogger.com/profile/06280912088483192599noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-89269726665573294022016-01-15T16:17:19.103-05:002016-01-15T16:17:19.103-05:00Thank you for your comment. I agree that family su...Thank you for your comment. I agree that family support is not the only factor, and certainly hormonal changes of pregnancy have a role to play in development of postpartum emotional complications. Here is how I address the issue in my forthcoming book.<br /><br />"Effective treatment of postpartum depression must include opportunity to address the issue in its full social and interpersonal context. This calls for acknowledging the massive biological and psychological shifts of motherhood, the reorganization of the relationship between parents, the role of the baby, as well as the normal ambivalence that accompanies this developmental phase. All this may be distorted in the setting of social isolation, severe sleep deprivation, and unrealistic expectations of rapid return to pre-pregnancy function." Claudia M. Gold, MDhttps://www.blogger.com/profile/13081419560269676730noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-87460299747294932752016-01-15T10:04:52.591-05:002016-01-15T10:04:52.591-05:00I hear what is being said but I think there is a d...I hear what is being said but I think there is a danger of ignoring the fact that many women DO suffer from post partum depression despite having amazing love and support from their husband/partner and family. I had a much wanted baby at 39 with the most loving, caring and hands-on husband who cherished both myself and our baby. Despite this I suffered from post natal depression and would sit with my baby in my arms and just cry because he was so beautiful. I ended up five years later with severe panic attacks and a major depression due to the job I was doing. Fifteen years later and three stays in a mental health clinic and I take my meds religiously every day and am able to function effectively in all areas of my life. The hormonal causes of depression are very real and need proper treatment - both with medication and therapy. I support your call for more support of new moms - it's essential - but if you are one of those mom's get medical help if you need it too. Jayne Coleman - Saffanachhttps://www.blogger.com/profile/14435250548792945440noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-85246755516313383992015-12-19T14:14:36.339-05:002015-12-19T14:14:36.339-05:00I think that science is also showing how important...I think that science is also showing how important prenatal care and support can be.Rosiehttps://www.blogger.com/profile/15103311792247520802noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-70008153280522744312015-12-19T14:08:18.466-05:002015-12-19T14:08:18.466-05:00Couldn't agree more, from personal experience,...Couldn't agree more, from personal experience, as a child, and as a mother, my children now in late 20's. I know this to be so true. So tragic that so many (in particular policy makers) just can't see or get it! Rosiehttps://www.blogger.com/profile/15103311792247520802noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-76919872698961688522015-12-15T17:19:56.410-05:002015-12-15T17:19:56.410-05:00I dont agree that family and support cannot fix th...I dont agree that family and support cannot fix that. A massive amount of hormonal in-balance come from sleep deprivation. In a culture where your only job is to sleep and feed the baby and yourself the effects of sleep deprivation would be significantly less. We also don't live in a culture where women feel permission to slow down causing adrenal fatigue and the stress hormone cortisol. Creating a truly safe place for a women to heal in solitude with complete ongoing care is significant. I don't dismiss genetic or other factors that contribute however I am also speaking from experience. I had full fledged postpartum depression 3 times - 1 extreme. When I look what could have been done to create a safe place for me to nurture myself I am 100 percent convinced that it would have lessened considerably. Andrea FITMOM Pagehttps://www.blogger.com/profile/05847087352482581960noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-87647613049429085662015-12-03T12:58:59.242-05:002015-12-03T12:58:59.242-05:00I agree with you, Sophia, and I only had one week ...I agree with you, Sophia, and I only had one week of my mother coming and helping after both of my pregnancies. I wanted help, but I think since in recent generations, the woman seemed to be expected to happily do it all, it was like, well, you should be able to do this all by yourself kinda expectation because I was and still am a stay at home mom. I was completely sleep deprived, and wished that there was another non-working family member that could stay with us in my home and help me 24/7 with housework and cooking. I breast fed, so the first month was especially tough with both of my children, because I was feeding them every hour and a half around the clock. I heard that in other cultures, there were groups of women that would stay with new moms and post pregnancy moms for upwards of half a year. That idea sounded fantastic to me! I wish that was the case for every mom.katiegfromtennesseehttps://www.blogger.com/profile/02703849303062043642noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-52769687275780863242015-12-02T19:40:00.193-05:002015-12-02T19:40:00.193-05:00Doulas are available today, in most major cities i...Doulas are available today, in most major cities in the US, but most chargeweareallequalhttps://www.blogger.com/profile/09953222945982262562noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-53701859199048912752015-12-02T10:15:08.078-05:002015-12-02T10:15:08.078-05:00Thank you! In the 70s we called these helpers &quo...Thank you! In the 70s we called these helpers "doulas." I haven't heard that term in a long time. Are there still doulas out there? MAybe that's something our ACA could institute.Philly Girlhttps://www.blogger.com/profile/06543951612451538559noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-39552555005822466772015-12-02T08:22:42.035-05:002015-12-02T08:22:42.035-05:00Thank you for this wonderful article. I will pass ...Thank you for this wonderful article. I will pass it along.<br /><br />Whenever I speak with a pregnant woman, especially a first-timer, I recommend La Leche League. My 2 children were born in the 1980s, a different age, but with no family around I needed and received so much loving support from going to LLL meetings. They give so much more than breastfeeding advice. I met a roomful of mothers and infants some of whom I still run into today. From the well-trained, experienced, compassionate and wise leaders I got so much information and advice about ALL aspects of caring for young infants and toddlers as well. And the child-rearing advice and philosophy is THE BEST. They knew then and know now the importance of the mother-child bond, the importance of fulfilling the needs of the infant and mother. I am often heartbroken by our culture that requires mothers to return to work within weeks or months of birthing. That baby needs you and you need her/him. Time put into bonding and caring fully for a baby and young child pays off 1000 fold because that baby will grow into a respectful happy and loving human. Priceless.<br /><br />Caitlinhttps://www.blogger.com/profile/05871140019922107240noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-77276467380544207122015-12-02T08:04:03.435-05:002015-12-02T08:04:03.435-05:00This is excellent. The pressure I felt, after my ...This is excellent. The pressure I felt, after my baby was born, to be happy, was horrible. <br /><br />I just have to give an anecdote. I was incapacitated mentally as a new mom. I couldn't function. And I felt like such a complete failure, and round-and-round it went, I was ashamed and miserable. I wasn't working out of the home but could barely manage to get dressed each day - trying to cook a simple meal was completely overwhelming. I made a list of 5 things to accomplish each day (because I had five fingers, and it had to be that simple) including getting dressed. I couldn't ask for help because I compared myself to all other moms and was consumed with shame..<br /><br />I finally mentioned this to my doctor. She said "Oh, I know what you mean, I was doing my residency when my son was born and I was EXHAUSTED". <br /><br />End of conversation.<br /><br />I sure coulda used one of them-there community support things.....Nancyhttps://www.blogger.com/profile/17563880830656090525noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-76743334009670540742015-12-02T07:27:33.502-05:002015-12-02T07:27:33.502-05:00HI Nicole
I agree that hormones have a role to pla...HI Nicole<br />I agree that hormones have a role to play and that more support will not solve the problem completely. My point is that we need to address the issue in its full complexity, which includes the social context.Protecting space and time to listen to the experience of mothers and fathers is critical. I discuss this problem in a more complete way in my forthcoming book, The Silenced Child, that will be released in May.Claudia M. Gold, MDhttps://www.blogger.com/profile/13081419560269676730noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-58725393734088373412015-12-02T07:23:03.575-05:002015-12-02T07:23:03.575-05:00
Thank you for your comment. Symptoms of PPD can l...<br />Thank you for your comment. Symptoms of PPD can last well beyond the first year. If you are still struggling, I would encourage you to seek help.<br /><br />Claudia M. Gold, MDhttps://www.blogger.com/profile/13081419560269676730noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-2072332321615783692015-12-02T00:40:37.490-05:002015-12-02T00:40:37.490-05:00A wonderful article. As a mother of 7, plus four l...A wonderful article. As a mother of 7, plus four losses, I have had many post partum times. My husband took as much time off as he could, and friends brought meals, after #3. For the first two, my husband had to return to work when I came home, and I struggled with ppd. I take a babymoon, now, staying in or around bed, as much as possible. Baby #7 had some issues, and we had to go to the dr a few times in the first two weeks. As soon as we got home, back in bed I went. My older kids helped a lot. My advice, if you have noone at home to help, is to find a homeschooled teenage girl. Many come from large families, so are very comfortable helping with baby, siblings, and the house. Rates vary in different areas, but can be affordable. Prepare at your baby shower. Gift cards for take out, vouchers for homemade meals, put cash aside to pay a helper. It will all pay off with a healthier, more emotionally stable mother. Even after an emergency c-section with #6, my recovery went well. Rest is under rated!!! Just BE with baby, drink them in. Really snuggle and nuzzle.Leoceahttps://www.blogger.com/profile/04577601977473643321noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-74121584472840235192015-12-01T22:49:30.788-05:002015-12-01T22:49:30.788-05:00Thank you for writing this !
Thank you for writing this ! <br />margery segalhttps://www.blogger.com/profile/08491588688514671961noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-87221966935910931532015-12-01T22:36:49.994-05:002015-12-01T22:36:49.994-05:00This is an interesting article. I agree that our s...This is an interesting article. I agree that our society expects moms to be back to "normal" (whatever that is) way too soon. I felt a huge pressure and I was a stay at home mom! However I dont think that you can say that if we fix this societal problem we will no longer have women dealing with postpartum depression.<br /><br />I agree that new moms need more support in every aspect of their lives. However you also cannot say that if women had more support there wouldn't be postpartum depression. Postpartum mood disorders are due to chemical imbalances and honestly, community and family support cannot fix that.Nicolehttps://www.blogger.com/profile/08473414761578048551noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-76306127911183757842015-12-01T18:15:33.989-05:002015-12-01T18:15:33.989-05:00I like this article and I wish society will act on...I like this article and I wish society will act on it. Nobody in my immediate family nor my partner seem to understand any of this. Therefore unfortunately we had a difficult first year and we are still struggling now that I have gone back to work. Does anybody know if Postpartum Depression only occurs in the first few weeks after birth or can it also happen later?Charlykphttps://www.blogger.com/profile/09581365281731228800noreply@blogger.comtag:blogger.com,1999:blog-8184208181444239184.post-80500589972546227682015-12-01T14:47:50.858-05:002015-12-01T14:47:50.858-05:00Excellent thoughts. I live near my extended family...Excellent thoughts. I live near my extended family and each week for 4 weeks following the birth of each of my two daughters a relative would come to my home and keep house when my husband was gone to work. They were there 24 hours a day, kept the house and (for my second) kept the older child busy. It was a lifesaver. <br /><br />That said, in hind sight I think I needed even more help. After 4 weeks I was planning meals, grocery shopping, doing light housework, caring for a toddler and an infant, and nursing around the clock. I had a very difficult recovery phase, and I think I tried to jump back into things too quickly. Next time I'm going to plan a slower transition back to "full speed." It's probably going to mean hiring help. 3-4 weeks of care is a great start, but it might not be enough--particularly if there are older kids involved. jubileesonghttps://www.blogger.com/profile/16387646159308001934noreply@blogger.com