More Reflections on Perinatal Bereavement Care
Part 3: To ease parents' suffering, practice "accept and connect."
Posted Jun 11, 2019
The previous post explained how to think about parents’ suffering as a normal, natural consequence of their baby’s death, and why parents don’t benefit when caregivers try to “protect and direct.” This post looks at the benefits of “accept and connect.”
When a baby dies, the parent’s journey can be painful and arduous. As a result, many caregivers feel uneasy and helpless in the face of such profound suffering. It’s normal to want to alleviate this suffering and minimize regrets. It’s tempting to try to “protect and direct,” as in, encourage parents to look ahead, reassure them that “this too shall pass,” and direct them to do x, y, and z in order to minimize regrets and boost coping. But “protect and direct” is a fool’s errand. Why? Because nothing can protect parents from the pain of their baby’s death. And when you take charge of parents’ experiences with their babies and their grieving, they can end up with more regrets, and feeling more alone and inadequate.
Still, easing suffering and minimizing regrets are noble causes. So how can you accomplish this mission with parents? Accept and connect with parents, so you can simply accompany them on their journeys.
To accept means being a nonjudgmental witness who accepts the parents just as they are, along with their experiences, their desires, and goals. To connect means being a companion who simply walks alongside parents on their journeys.
Here are some tips for effective practice of accept and connect, as in, how to be a nonjudgmental witness and companion:
- First and foremost, be aware of your own feelings of empathy and helplessness in the face of great suffering. When we empathize and feel helpless, we suffer too, which is why we can be so eager to "protect and direct." (See next post for more on this.)
- Remember to frame the parent’s suffering in terms of going through a difficult but normal, natural, necessary process, and recall the benefits parents reap when they are in charge of their own experience. (See previous post for more on this.)
- See each parent as a competent, resilient adult who can find her or his own way. Parents may look like emotional messes, but it’s temporary and only because they are in great pain. Even when falling apart, they are still competent, resilient adults.
- Practice healthy boundaries, as in, know where you end and where the parent begins, so you don’t get over-involved in their process. It is not therapeutic to “help them grieve, recover, and move on.” Instead, stay out of their way so they can take charge of their experiences.
- See their journeys as theirs and valid for them. It’s not for you to second-guess.
- See them as being in charge of their pace, their coping strategies, and their hope. Resist directive statements or patronizing attitudes like, “There’s a time to mourn and a time to heal,” or “Let’s get you moving,” or “I can show you the way out,” or “I’ll hold on to your hope while you’re feeling hopeless.”
- Slow down. A show of this can be as simple as sitting at the bedside, instead of standing. Or reassuring parents that they can take all the time they need to make a decision or that they can keep their baby (and even take their baby home) for as long as they want. Taking a moment to breathe deeply before you enter the room is also a way to exude “slow down.” For distressed, overwhelmed parents, goals like efficiency, quickness, and high productively only add to their stress and confusion. S l o w d o w n.
- Hold space for parents to be who they are, how they are, and where they are. When you hold space, parents can feel safe, valued, and self-determining, all of which boosts coping and resilience.
- Be clear about what’s their job and what’s your job. Remember that it’s not your job to “fix it” or tell them what to do, how to grieve, or how to find meaning. Determining meaning, how to grieve, and what to do is their job.
- Your job is to connect and accompany them on their journey. To do this, provide a listening ear, hold space for their feelings and experiences, make unbiased, non-directive observations and suggestions, and support their efforts to determine what they need, what works for them, where they find meaning, and which practical coping skills they want to acquire.
- Finally, make room for parents be the heroes of their own journeys. You be the hero of yours.
When you practice accept and connect, your presence as a nonjudgmental witness and companion is therapeutic in the following ways:
- You demonstrate healthy boundaries—that you know where you end and the parents begin—which enables you to support but not intrude in their business.
- You show parents that you trust their ability to be in charge of their experience, determine what they want, and figure out what would be meaningful to do with their baby.
- You show confidence in parents—that you see them as competent people, even when they feel so incompetent in the face of unspeakable tragedy.
- You show that you have faith in their plan, their pace, and their path.
- You show that you respect their perspectives, feelings, ideas, and their uniqueness as individuals as you follow their lead.
And how exactly does this practice ease parents' suffering?
Your boundaries, trust, confidence, faith, and respect—all of this reflects back to the parents that even though they feel utterly broken, you see their wholeness and have confidence in them, that they can survive the death of their baby. Your trust in them and faith in their journeys feeds and waters tiny seeds of resilience, which can germinate and see them through their darkest days.
Plus, when you accept rather than try to protect parents from their pain, parents can feel your compassion, which is actually the most soothing balm. When you connect rather than direct, parents can feel truly comforted by your companionship.
Furthermore, and most important, practicing accept and connect can help you avert the occupational hazards of burnout, empathy fatigue, and vicarious trauma, which are all-too-common for caregivers like you, who engage in this valuable and potentially heartrending work with grieving families. When you can remain fully present and at ease in your work, you can be a more effective practitioner of accept and connect, and better able to ease parents' suffering.
The next post in this series explores the difference between compassion and empathy, plus how practicing compassion enables you to accept and connect with parents, increases your professional fulfillment, and protects you from burnout, empathy fatigue, and vicarious trauma
Time to Care: How to Love Your Patients and Your Job, by Robin Youngson, M.D. CreateSpace Independent Publishing, 2012.