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    There are many different forms of PTSD and there are a variety of
    treatments most of which are quite effective.

    However an early sharp focus on PTSD aspects of a mother’s distress can be a trap for inexperienced therapists. A wider view of their overall development, family of origin and its role in the loss of the baby, their level of adaptation to everyday living, the presence of functional close relationships, including employment, and their ability to cope socially with their immediate issue of getting to the therapist and accepting a professional relationship all need to be thought through carefully for issues that may be more urgent to them.

    Thus my experience with a wide variation of mothers who have lost a baby to adoption is that the de-briefing assessment stage is long and needs to be detailed at the mother’s own pace. Even with a motivated mother and hour-long sessions I find I am finding new aspects of her PTSD or grief after many sessions as she becomes able to trust the therapeutic alliance and knows her feelings are received, contained and comprehended. It is important to say that this is difficult indeed to be with intense, unusual and alarming feelings that were new to a young man in his early thirties no matter what his experience in obstetrics was. I am indebted to the numerous mothers who serially taught me about these fearful occurences and and prepared me for the many I was to hear from then on. It was this learning the later ones would hear in response, and above all , helped me to be oriented to the traumatic field behind it.

    When there has been abrupt shock without support, followed by protracted fear it is important to be able to expose and share the feelings with the therapist. But the damage often leaves only a short intrusive picture, like a short video clip, sometimes it is a sound or a particular smell. The lead up and the actual scene and its happenings is often absent. In therapy one can’t help this without replacing it with a more everyday series of thoughts and memories to represent that circumstance whether they come back or are still amnesic.

    This is sometimes done with systematic cognitive behaviour therapy which has been planned around the distressed memories and the confused thoughts and beliefs that have remained. Your build together new thoughts and memories around the traumatic
    Event and it is as if you have found the damaged part of your hippocampus and are tidying it up together. At this stage mindfulness therapy can build a good platform for long-term benefit.

    Other therapists use bilateral sensory therapy to help blocked brain function. Some of these are simple and inexpensive, some formal and very expensive. However they may not work, particularly when followed up in the longer term.


    Dr Geoff Rickarby Consultant Psychiatrist
    November 2014