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Interview with Dr. Mara Tesler Stein: Perinatal Trauma & EMDR Therapy

– Hi, I am Dr. Mara Tesler Stein. I’m a clinical psychologist
and I am based in Chicago. Perinatal trauma is any
sort of traumatic experience that happens in what we define
as the perinatal period. And so let me tell you what that is. Perinatal period starts
from trying to conceive, through pregnancy, up until
the first year after delivery. So it’s actually quite
a long period of time and you can imagine, there
are many, many, many, many kinds of events that happen to families. So the kind of classic example that I think people tend to think about when they think about perinatal trauma, might be something like a
traumatizing birth experience. So a birth experience that
is overwhelming, painful, medically frightening, where the mother or others feel, like, fear
that the mother might die, the baby might die, or in
fact if the baby does die, or sometimes mothers die. So that overwhelming fear
and pain and confusion can happen in a really
traumatic delivery situation. It’s one example. Another category of
perinatal trauma might be the death of a baby at any point during pregnancy, during the birth, and in the perinatal or newborn period. And there are any number of reasons and ways that that can happen. And very often, how it happens
is even more important, in terms of it’s impact, than what happened or
even why it happened. So like most trauma, the experience of it, the meaning of it, what I
tell myself it means about me, my family, myself, my
potential to have this family that I’m trying to build, how it hooks up with old experiences. Like with any other trauma,
but in family building, there are so many points of vulnerability. And when you look at
it you realize, oh wow, there’s a lot, you know
there’s the pregnancy stuff, there’s all the things that can happen over the course of a pregnancy, stuff that can happen to the mom, things that can happen to the pregnancy, things that can happen to the baby. And all three, of course,
are critically important to have a live, healthy
baby and a live, healthy mom at the end of a pregnancy. I was a relatively new therapist, I’d always been fascinated with trauma. I’d already done a lot
of work with infancy, early childhood development,
taught child development, done a lot of parenting work. All these pieces were there. And then when I discovered
I was pregnant with twins, I thought, cool, this is great. And my OB was like, ah,
it’s a high risk pregnancy, I thought, oh no it’s okay. And then I went into
preterm labor at 24 weeks. And before I knew it, my regular day, which was gonna be doctor’s
appointment in the morning and then a regular work
day the rest of the day, ended up with me in a
hospital bed on magnesium to try to stop contractions
of preterm labor. And that started this journey that is really still
ongoing, 23 years later. Through a prolonged hospital bed rest and then my daughters were born at, they were 10 weeks early and they spent 10 weeks in the hospital. And throughout that whole
time, I can remember thinking, could you send somebody
to talk to me? (laughs) This is really hard and
sort of all I got was, oh yeah, this is hard. I’m like, yeah, (laughs)
that’s all you got? (laughs) And it’s disorienting and it’s confusing and it’s overwhelming and
even as a psychologist, who knew lots of stuff, I
was absolutely overwhelmed. I was terrified. I needed something, I didn’t even know exactly what I needed. And through the NICU stay
I felt very much the same. Trying to grapple with,
what do I need here? What’s wrong, what’s wrong with me? Is there something wrong with me? And then when the girls came home and I finally got my hands on the very few books that were available for parents of premature babies, you know, open them up, I’m looking. I don’t care about the medical
stuff, yeah okay, okay, I’m looking at anything about emotions. And really, there were like
three paragraphs on loss, two on shame, one on
angry, something like that. And I thought, okay, either there really is
something wrong with me, or they’re missing something. And it took a while, but when I found the community of other parents of premature babies, I realized it wasn’t just me. I wasn’t crazy and I wasn’t alone. And it changed everything. And so it really ignited this passion to do this work and to learn
about what happens to people in the midst of these kinds of crises. And it has been a really
incredible process. As I got more and more involved
in perinatal mental health and what I found was
that our standard ways of working therapeutically, which we all know are
wonderful and powerful, would bring the work to a
point and then it would stall. And I couldn’t figure
out what the problem was. And I’d been hearing about EMDR and like a lot of people
thought, ah really? But I thought, well,
I’m really getting stuck and it’s clearly related to trauma and maybe I ought to get trained in this thing and see what I think. So I went to a part one training and well, this is pretty cool,
it makes sense, I get it. And I came back to the office and the first person that I did
EMDR processing therapy with was a woman who’d had,
who had had a baby die in the middle of a pregnancy and had had to make some decisions about how to proceed during the crisis and she was actually pregnant
again already at that point. And was a lot better than she
had been when she walked in but was really still stuck around some of the critical moments during that first pregnancy and that loss. And we did phases three through seven and I remember thinking,
this can’t be real. She must have read the book. This is unbelievable. It felt like watching ice evaporate. It didn’t even have to melt. It just, it felt like this
thing that had been stuck, just shifted and moved. And she was kind of blown away. We were both kind of blown away. And it just sort of released and processed and digested this last bit that had really been impossible to get to. And really she wrapped up a session later, two sessions later and
the next thing I got was a birth announcement with a picture. As I became more and more involved with maternal mental health community, what I was hearing from people was, I really want to get trained in EMDR. But I really would love it
to have a perinatal focus. And of course people not knowing what the foundational training looks like or even what the model looks like, didn’t know even what that would be. So what I said to them was, you know, when you’re learning the model, you really need to learn the model. And that’s really what
we’d be focusing on. There really isn’t any reason to have like a perinatal specific training because the way that
you would use the EMDR with this population on it’s face, is the same as you would
with any population except, what would it be like to train with other perinatal specialists and how would it feel to have your trainer be an expert in perinatal mental health and perinatal trauma? Would that make a difference? And the response that I got was, oh yeah, we’d really like that. And the questions and
certainly in consultation, can be perinatal focused. We can use those examples and we certainly have plenty. And then people can go on to
do more advanced practice, EMDR training, which can drill
down much more specifically, with much more nuance about
how we can apply EMDR, because it is such a robust model. And people really seem to like that. So I’ve started to invite, essentially to hold these training and say, hey, this is an invitation for perinatal mental health people who want EMDR training to train with their fellow specialists. The energy in the room
and feeling of belonging and the feeling of being
understood as a clinician, working with this population, the things that you worry about, the things that you think of, attachment, maternal infant health, issues around loss, issues
around the medical system. It just goes on and on. But the excitement of
being with your people and talking about this stuff together and then weaving the AIP model in, helping them to then translate what they already know into our AIP model, helping them to understand
what they’re looking at through this lens and
helping them to understand the kinds of maternal mental health stuff and family perinatal mental health stuff that they might not have
thought about as trauma. When you look at all the kinds of things that can happen through that lens, we can understand how we
can help more effectively.

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