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Taboo or not taboo: Perinatal grief and gestalt therapy

Two years ago, I conducted a study on perinatal grief: the loss of a baby, either in the womb or shortly after birth. Five bereaved mothers came to me for psychotherapy sessions. I have myself lost a baby, ten years ago, during the 9th month of pregnancy.

Here are some excerpts of the 30 pages study.

Introduction
Purpose of this study
Methodology
I- Perinatal grief
Definition
Literature
Some facts about stillbirth and perinatal grief
Theoretical grounds: grief / trauma / taboo
II- Supporting mothers who have lost a baby
The clients
Discussion: different places in trauma and mourning, different ways of working
Conclusion
Appendix: Perinatal grief, common grounds
References

[…]

Purpose of this study
On the top of my personal interest, other reasons made me pick up the subject. Firstly most people actually know someone who has lost a baby prior to birth (even if they don’t always know it). Secondly, I quickly found out that the field is quite unresearched in gestalt therapy (GT). Thirdly and probably most importantly: parents who go through this painful experience often don’t get the support they need, and my hypothesis is that it’s because of the taboo that surrounds it. And finally, I believe that exploring such a subject might also give us keys for understanding how to cope with any difficulty in life, big or little.
The purpose of this study is therefore to qualitatively explore the subjective experiences of mothers who have lost a baby. It focuses on trauma and on dealing with the taboo(s). My research question is :
How does the taboo influence the quality of contact as well as the intensity of the trauma and the grieving process?
And consequently: how to use GT to facilitate this relational challenge and relational healing?”

[…]

Theoretical grounds
The works I mentioned above show that even if parents have different experiences, one can find a large number of similarities (see Appendix for more details):
– the death of a baby is a traumatic event and a social taboo; parents feel abandoned, stigmatized and responsible for others people’s emotional reaction
– this loss is often underestimated in depth and duration by the environment (and the parents don’t always dare to show their feelings, fearing that the others will think that
they exaggerate); the parents see themselves as parents, but the environment doesn’t always
– the environment often fail to support the parents, for example when saying wellintended sentences which actually hurt the parents (“You’ll get another one” or “That is probably better this way”, etc.).
– to be able to hold the baby, collect memos, create a social identity, say goodbye and keep the baby alive in the family memory seem to facilitate the grieving process and reduce risk for depression and worsened mental health
– the most important key for the grieving process seems to lie in the possibility to process and share one’s experience with others – while the environment often avoids the subject
– it can create a gap between the parents (separations are common) or in some cases an opportunity to come closer
– when successfully processed, it can be an occasion for self-growth – otherwise it can affect the parents deeply even many years after

[…]

Taboo
Death in general is taboo in our societies. Sabar (2000:157) writes that it is “hidden”, “only read about or seen in the news”:
We turn away from it, fearing contamination or not knowing how to relate to it, often avoiding people who are dying or bereaved, as well as resisting expression of our own loss and grief.
About stillbirth in particular, Kelley and Trinidad write that “the grief and devastation are deeply felt but not socially recognized” (2012:14).
Something very peculiar is that there exists no word (in English, French, Swedish…) to refer to “a mother/father/parent who has lost a child”. As if we refused to think it was possible. This absence of word sounds almost like the “magical thinking” – in that case: if there is no word for it, it cannot exist. The magical thinking starts during the pregnancy: the parents reading books on pregnancy usually skip the chapter on stillbirth, convinced (or convincing themselves) that it is something that only happens to others. The physicians avoid to directly use the word or the topic if any sign of problem is detected during the pregnancy (Kelley and Trinidad, 2012). Stillbirth is the “inconceivable confrontation of the double mystery of life and death” (Soubieux, 2009:3).
Therefore, losing a child, and particularly before birth, is a taboo. According to the Collins English Dictionary: “If there is a taboo on a subject or activity, it is a social custom to avoid doing that activity or talking about that subject, because people find them embarrassing or offensive”.
[…]
The different studies I listed report the importance of the words we use and how language creates meaning. They show that the parents too often get hurt by the words or by the avoidance of the subject. Jonas-Simpson and McMahon (2005) argue for a very carefully chosen way of speaking to parents who have lost a baby, in order to avoid harm and to honour the baby instead. That is: for breaking the taboo. They recommend to really consider the baby as a baby, their child, and the loss as a death. To listen to the parents and let them express what they experience and what meaning they make out of it. One can ask them “how do you connect with your baby?”, “what was his/her name?”, “how old would he/she be?”.

[…]

Conclusion
[..]
My research question was about dealing with the taboo, its influence on the intensity of the trauma and on the grieving process. My client-cases indicate that how well the mothers go through the grieving process is directly connected to the size of the taboo. The taboo induces a poor quality of contact (confluence and deflection), presses down the trauma and creates unfinished gestalts – difficulties on the mourning path. On the other hand, a good contact, through an authentic and empathic dialogue, in particular with the father, is healing. This study also shows that an important theme for the mothers is the place they make in their lives for the dead baby. This place is of course more easily found when there is no or little taboo.
GT (Gestalt therapy) can be used to break the taboo, work with trauma, develop resources, facilitate contact and organismic self-regulation, feel and put words on bodily sensations and emotions, experiment, and maintain a healthy bond with the dead baby. To me, above all, breaking the taboo is about opening up for a dialogical relationship with the parent and let oneself be touched.
To lose a baby is a traumatic life-changing event which can be devastating and/or a possibility to develop resilience and grow. The therapist’s task is to accompany the parent along the grief process, and to dare breaking the taboo. “You could say that the grief process consists of making the baby accomplish a life, his/her life: the less [he/she] has lived, the more the
potential of his/her life that remains, and the more difficult the mourning will be. The grieving process would be the time needed to realize that this life was accomplished and in what ways it was” (ibid.:35).”

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Don’t hesitate to contact me if you have any questions (or if you want me to send you the whole study).

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I will hold an online grieving parents group together with my colleague Aglaia Michelaki: Imprints on the heart, starting 21st October 2020. More info here.