I feel compelled to write about shame both as a mum of three and a Clinical Psychologist because it is the thing that shocked me most about becoming a parent and I see its impact on perinatal mental health every day in my clinic. I think this might just be the most important topic in this series I am writing about perinatal mental health, at least to me and perhaps to a few of you too.
I want to begin with a question. What am I supposed to do with this when it happens in Boots?
Photo by Juanmonino/iStock / Getty Images
If you have an answer to that I want to meet you and shake your hand because I’ve exhausted all the options I can think of over the 8 years of parenting I have done.
I never figured out what to do when a child decides the apocalypse is nigh in public. My instinct has always been to stay calm, do what we have to do, and just sort of try and comfort them (in technical terms I guess you could say I try to co-regulate to bring them back within their window of tolerance but I am not really thinking of that in the moment!)
The link between shame and perinatal mental health
When I first became a parent I naively believed that most people understood that sometimes an 18-month-old will just be inconsolable for no apparent reason and if you need to get them a medically necessary prescription and some nappies you are just going to have to ignore the tears while you try to put on a cheerful face for the nineteen-year-old sales assistant. When my eldest was 18 months and inconsolable in Boots, I found out I was mistaken.
24 hours after the gates of hell opened on our local high street I returned to Boots to pick up the remainder of my daughter's prescription. The same sales assistant was on the checkout and as I saw her I greeted her in my usual cheerful manner. I had pretty much forgotten about yesterday’s tantrum, they were too frequent to warrant individual memory formation. She said this: “Oh hi it's good to see you again, I was worried you wouldn’t come back. I told them yesterday, I said, whatever you say I think that girl’s a good mum. I think its good you stay relaxed when they are crying. I couldn’t believe the things they were saying about you. So nasty. We all have bad days don’t we?”
SO. MUCH. TO. PROCESS.
I’m not going to go into the myriad of social issues that comment brings up. This blog could turn into a book. Instead, I am going to focus on how it made me feel. It actually hadn’t occurred to me before that people might have been judging me when I pushed around my little mandrake and her dozing brother but this well-intentioned sales assistant changed my worldview irrevocably. I scuttled home, barely able to make eye contact and too fearful that one of them would wake to finish running my errands in town. There was no mistaking it, eyes down, shoulders hunched, activated threat system. I was feeling shame, depression’s best and meanest friend.
It had been six weeks since the birth of my son and consequently, I was more vulnerable than usual. I would not normally feel such crushing shame at the flippant comments of a stranger. So how then did a well-intentioned young lady manage to unleash a beast of self-doubt upon me in Boots? I turned to Michelle Cree’s book on the Compassionate Mind approach to postnatal depression for some answers.
The evolutionary reason shame and perinatal mental health are linked
Cree’s work has become my bible when working with expectant and new parents and I also use it for self-help whenever I need to. Her down-to-earth, sensible evolutionary perspective on why we can feel shit at the most joyful time of our lives makes sense to me and as usual it had some wisdom on this subject.
Cree suggests that as new parents we are particularly tuned in to social comparison because in our evolutionary past the survival of ourselves and our young would have been dependent on us maintaining a decent position in the pack. We are therefore programmed to experience shame when we sense we have done something others disapprove of. When you think about all the things we stress about after having babies this makes total sense. Breast or bottle, dummy or thumb, work or stay-at-home, routine or baby-led, fitting back into our pre-pregnancy jeans. All of these topics have a strong thread of comparing ourselves to others running through them.
Shame, unpleasant though it is, actually serves a purpose. When we feel ashamed our body language becomes small and submissive and that might just have got us back in the good books of the alphas we needed to protect us and our babies. As I mentioned, shame has a pretty cosy relationship with depression and there is also an evolutionary explanation for that. If we were feeling shame frequently it was probably because we were permanently out of favour with the alphas and therefore were likely to be lacking in muscle to protect us. It made sense for our brains to tell us to stay quiet, remain awake and never leave the cave. That sounds a lot like the insomnia, lack of motivation and low self-confidence that are often associated with what we call “depression”.
Cree’s view of perinatal mental health is multi-faceted, social comparison and feeling judged by others is only one part of it. I’m going to be exploring other things that make us particularly likely to feel depressed and anxious in the perinatal period in the rest of this series of blog posts but this was where I had to start today.
How to protect your mental health during pregnancy and in the post-natal period
My experience of the highs and lows of pregnancy and having a newborn has further convinced me that mental health is a key issue for us all. Just like our physical health, I believe we all have times of mental fitness and times when we need a tune up to get ourselves back in good mental condition. It all seems pretty natural and inevitable to me. Things tend to get really difficult for people though when they don’t recognise what is going on in time to nip it in the bud. Allowed to run riot shame can be such a destructive emotion, making us withdraw from anyone who could help us and making our world so small we can’t see anything worth living for. That is why I am so passionate about encouraging women to take charge of their mental health during pregnancy and the post natal period through my blog, the mental health workshops I offer to organisations and therapy.
For now these are some evidence-based strategies you can try if you are feeling like you need a bit of extra self-care today:
Reach out – if feeling negatively judged causes shame which causes depression it makes sense to me that getting some positive feedback from people you love and respect could undo some of the damage. Seek what you need from those you trust.
Compassion – Cree shows us how we can use mindfulness and compassion to soothe our minds when we feel under threat from judgement. I recommend reading her book to learn this from the ground up but one exercise I really like and have adapted for myself is the compassionate letter. This involves imagining being a totally non-judgemental, kind and wise version of myself and writing to myself as that person. When I am feeling low it helps me to think about what a truly compassionate person would say to me if they were here. It can be hard to do but I always find it valuable when I make the effort.
Endorphins – Resist the urge to stay inside and hide and head out for a power walk or do some gentle movement that you enjoy. The endorphins from physical exercise and sense of achievement from taking back some control will both help to shake the shame.
Need some help with your mental health?
If you are struggling with feelings of shame or depression and it feels like too much for self help have a chat with your GP about talking therapy available on the NHS or consider private therapy if you feel that would suit you better. I offer online and telephone therapy as well as in-person based on the compassionate mind approach. If you want to talk to me about my approach to therapy or to ask for general advice about how to find a therapist please contact me.
If you are pregnant and want to tune up your mental health to prepare for the highs and lows of pregnancy and the post-natal period sign up for my free blog and podcast over on Substack.
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