THE VARIED PRESENTATIONS OF PTSD continued

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AVOIDANCE

While many of these described above were associated with special circumstances, the one that was obvious across the broad range of mothers was observable in their avoidance behaviour. Triggers would bring back post-traumatic images similar to the ones experiencing intrusive images. The salient one is that 45% did not go one to have another child as they were supposed to do. The elaborate means that the others took to avoid any of the circumstances of their first labour was detailed and obsessive and even then the circumstances would trigger the horrors of their fears during the first labour. They would often have behaviour inexplicable in their anxiety and obsessive avoidances and resisting various procedures and even positions. Many had not disclosed to anybody they had a previous baby and it was a shamed secret which process itself destroyed their personality as I have described elsewhere.

But to avoid doctors, nurses and hospitals generally was so common that treatments for many urgent medical requirements were not done, not made, or disastrously delayed. This was seemingly inexplicable, unless you asked as I learned to do.

Some of the women did not tell me until many years of therapy that they avoided babies to extreme degrees. A friendship was ended or not begun because there was a baby or young child there. This would seem to be grief on the surface but when examined, there was a compulsive return to a wide series of post-traumatic issues that were being avoided. In a long therapy this was not able to be extinguished, but on the other hand the bleak life led by the patient lifted from self-deprecation, unhappy preoccupations, frank miseries, and left a better capacity to have fun.

TRIGGERS

We have discussed above their avoidance of triggers to do with hospitals, doctors, labour-wards and even having another baby. Triggers that are associated with humiliation and injustice deep within their damaged self can’t just be physically avoided.
Language itself is the common medium. They hear of relinquishing mothers as if they don’t know what the word ‘relinquishing’ means. To them it is a blatant socio-cultural lie. Other words such as ‘chose’ inflame them like the word ‘Chosen’ sets off a lot of early teenage adoptees. ‘Decided’ is another word that will provoke ironic laughter.
At the Federal Governments Apology senior members of the Inquiry were aware of the distress that such inappropriate words might have on the mothers and an offer had been made to The Leader of the Opposition Mr Tony Abbott to help him with this issue. It was not taken up. As a result terms such as ‘birth mother’ were used and aroused cries of protest around the auditorium. Fortunately an aboriginal mother in the front row very close to him was able to communicate with him clearly early in the speech, and he was then heard in silence. He came up to her afterwards and warmly thanked her for her assistance.

 

Dr Geoff Rickarby Consultant Psychiatrist
November 2014