My advisor, Wendy Phillips, is an intellectual badass and heartbreaking visual artist. She curates an art show each residency to showcase the work of students throughout the program. Because the program is so very much DIY, there's room for creative work in a way that I haven't found anywhere else in academia. As Wendy says, "I keep thinking they're going to come in and tell me 'You can't do that!' But they haven't yet..."
I exhibited a prototype from a workshop I designed last semester in my course on group therapy. You may have noticed I'm interested in maternal health (ya don't say?), so I wrote my final paper on this idea: designing a hands-on workshop for mothers pregnant after experiencing loss. The product of the workshop would be a baby-carrier, dyed through the traditional Japanese art of Shibori.
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| Shrouded Shibori by Holly Brackmann |
Social support is so important in facilitating the movement through grief. And I feel that the process of working with textiles is something akin to the process of creating a baby: painstaking in one way and yet so comforting as well; following a pre-determined design but also touching an element of the unknown; and in its cultural coding, entirely feminine.
I posted a link to my residency write-up on my Fb page and there was some interest in reading a bit more about this project. So here's the paper I wrote, interspersed with some screenshots for the workshop, which will probably never happen but was really fun to write about.
Shibori Healing: Textile-Based Group Therapy for Mothers
Introduction:
The
relationship between parent and child is one of inter-dependence and
shared identity; the grief experienced from its loss is almost
necessarily 'pathological' in nature (Rando, 1993). Perinatal death
(the loss of a child1
at or around the time of childbirth) is experienced by the parents as
a profound tragedy with existential ramifications reaching the very
core of self-understanding (Taubman-Ben-Ari & Katz-Ben-Ami,
2008). Societal treatment of parents who have lost an infant,
however, does not often acknowledge the magnitude of this grief
(Rando, 1993). In addition to the pain of loss, mothers report
feeling stressed, isolated, and misunderstood.
The
situation becomes further complicated when a mother who is suffering
from perinatal loss becomes pregnant again. Carrying her 'Rainbow
baby' within her, she may experience relief from some of the most
severe symptoms of her grief; relief may also bring guilt. Outsiders
might congratulate her on 'becoming a mother again' or anxiously
refrain from discussing her past pregnancy for fear of causing 'bad
luck'. Extra medical attention may feel warranted, or it may increase
her anxiety. She may worry that she will not be able to bond with her
child.
The
intersection of stress and joy at the prospect of a new child, and
remaining grief and fear from the loss of a previous one, is an area
particularly dense with psychological need. Therapy designed
specifically for mothers in this situation, however, is almost
nonexistent. The benefits of designing an effective therapy for this
population could have long-term positive effects: the anxiety and
depression experienced by mothers after perinatal loss can also
interfere with their level and style of attachment to the new child
(Gaudet, 2010). Mothers who receive counseling and social support
undergo shortened bereavement reactions after perinatal death
(Forest, Standish, & Baum, 1982). Therapies that address this
issue with mothers pregnant again may enhance their abilities to
relate with their children.
Issues
Associated with Carrying a Rainbow Baby: Terminology
"Rainbow Babies" are the understanding that the beauty
of a rainbow does not negate the ravages of the storm. When a rainbow
appears, it does not mean that the storm never happened or that the
family is not still dealing with its aftermath. What it means is that
something beautiful and full of light has appeared in the midst of
the darkness and the clouds. Storm clouds may still loom over but the
rainbow provides a counterbalance of color, energy, and much needed
hope (starwarsmama, 2010).
The
terminology used to describe a deceased child is laden with emotion,
reflecting the light through which the speaker wishes both the child
and their passing to be seen. One comment thread recently posted in
the Facebook group, 'Defiling Photos of Dead Babies is NOT ART!'
(created by a bereaved mother with the intention of pressuring the
creator of the 'Stillborn in th3 USA' series to redact and apologize
for her work), discussed the issue of the group's title. A group
member took exception to it, stating that, “I am only speaking for
myself but the name of this group bothers me in that its name
contains the phrase "dead babies" which I find offensive.
My child may have died but I would never refer to her as my dead
baby” (Leif, 2012).
The
term 'rainbow baby' is used to denote a child born after parents'
previous experience of the loss of a child to miscarriage,
stillbirth, or other fatality. Like 'angel baby' (a deceased child),
the term is ambivalent, referring both to joy and grief. Mothers use
it to express the healing power of re-engaging in processes of child
conception, childbirth, and child-rearing.
The
term, however, has not been adopted by medical professionals, who
seem more likely to use the rainbow metaphor to market their services
as child-friendly (e.g. the University Hospitals 'Rainbow Babies and
Children's Hospital' in Cleveland, OH) or in reference to the adopted
children of LGBTQ couples. Even within parenting loss support groups,
the rainbow metaphor has its detractors. Some Christian mothers find
it denies the goodness of God; others find its additional association
with LGBTQ causes distressing.
Uses
of 'Rainbow baby' must also be seen within the context they occur:
the lexicon of parenting groups, many of which use a register that is
cutesy and decidedly non-medical. For example, other terms include,
'BFP' (Big Fat Positive, a positive pregnancy test), 'Sticky dust'
(wishes or prayers for a healthy pregnancy not leading to miscarriage
or loss) and 'DTBD' (Doing the Baby Dance, or having sex). The
success of these parenting groups may indicate that American women
feel a need to pursue advice and support regarding reproduction
outside of the medical field.
Issues
Associated with Carrying a Rainbow Baby: Ostracism
I'm
sorry you can't see him, but I feel him always, all around me. He's
definitely here. I'm not contagious. It doesn't rub off. Why do
people freak out when Caleb's name is brought up? Why do certain
members of my family completely ignore he ever existed? Why have long
time friends just up and block [sic]
me from their lives? I don't believe I've been a self pity party. I
think I've done quite well. So what's the big deal? Everyone freaked
out about death that much? (Evans, 2012)
The
social isolation that often accompanies the loss of an infant can
have devastating effects (Doka, 1989). Parents experiencing intense
grief without knowledgeable support can feel that they are losing
their minds (Rando, 1993). The dramatic change in social role that
accompanies pregnancy (Taubman-Ben-Ari & Katz-Ben-Ami, 2008) and
its subsequent loss in the case of perinatal death can lead to
uncertainty as to how to interact with the world (Gaudet, 2010). It
has been hypothesized that strangers, friends, and even close family
members do not develop the same kind of attachment with a child
in-utero as the parents (Rando, 1993). Thus, their need to grieve the
loss of their unborn or stillborn child is never fully understood.
Issues
Associated with Carrying a Rainbow Baby: Depression and Attachment
It's
rough but we're just trying to get by. I think it will be harder on
me as it gets closer to February and...[our earlier son's]
birth/death date, and when (if) I'm in the 3rd trimester or whatnot -
just movement might be hard. I may have a really hard time "bonding"
with the pregnancy, for sure. I think i might really hold back
(ekandrmkb, 2011).
While
it is important and valuable to provide emotional support for
grieving parents, efforts to address the emotional complications
present in post-loss pregnancies also have a broader significance.
Infants of mothers with clinical depression, particularly during the
last trimester, are more likely to show disordered capacity for
neurorelugation (Goodman, Rouse, Long, Ji, & Brand, 2011; Glover,
Bergman, & O’Connor, 2008) marked by infant disorganization and
fussiness in general (Hart, Field, & Roitfarb, 1999; Lundy et
al., 1999; Zuckerman, Bauchner, Parker, & Cabral, 1990).
This
can set a negative stream of interactions in motion, as emotionally
withdrawn post-loss mothers face the additional challenge of bonding
with a fussy baby (Goodman, Rouse, Long, Ji, & Brand, 2011). Some
researchers (ibid.) have recommended that healthcare providers
monitor women they perceive to be at greater risk for antenatal
depression, assessing their infants for fussiness and helping mothers
learn coping and calming mechanisms in caring for their newborns.
Issues
Associated with Carrying a Rainbow Baby: Medical Management:
When
I labored with my first I was told I was incapable, that my body
“couldn’t” do it, that my contractions were inadequate, that I
wasn’t dilating fast enough, then that I couldn’t push him out. I
was forced to have medicine that almost killed him by putting him
into severe distress, then I was forced to have him cut and sucked
out of me because of my “inadequacy” (Renee, 2011).
Women
with access to healthcare are often monitored more closely in
post-loss pregnancies. In many cases, the causes of previous
stillbirth or miscarriage remain unknown and the medical management
of the subsequent pregnancy is pervasive, conducted as a matter of
course. Women have conflicting feelings about this management (e.g.
LRusso, 2012; Renee, 2011). Some find that increased management
allays some of their fears and validates their efforts to provide a
safe environment for foetal growth (LRusso, 2012). Others find it
invasive, exacerbating their fears of worst-case scenarios (Renee,
2011). And still others feel that their pregnancy is not being
monitored closely enough.
Like
patients with medical illness, pregnant women interface with medical
procedures and professionals on a regular basis. Their feelings about
this involvement must be taken into account in the design of further
healthcare therapies, including psychological work.
Issues
Associated with Carrying a Rainbow Baby: Pregnancy as a 'Coping
Mechanism':
I don't know if since
Carys' arrival if I have had much time to remember Jayne, of course I
still think about her every day, but Carys keeps me so busy, I'm not
sure I'm able to continue to process the grief in the same way. Is
this a good thing? Is this the next stage, integrating Jayne into a
family that's here with me? Or ought I to make a space for my
relationship with Jayne? A time for just me and her? How does anyone
else manage mothering rainbows and angels?(JulyBaby,
2010)
Little
or no research has been conducted into the reasons behind and factors
contributing to the decision to have another child after perinatal
loss. While there are mental health contra-indications for becoming
pregnant soon after, such as increased risk for anxio-depressive
symptoms (Gaudet, 2010; Forest, Standish, & Baum, 1982), an
estimated 86% of women become pregnant again within 18 months of
suffering perinatal loss (Cuisinier, Janssen, Degraauw, Bakker and
Ogduin, 1996). Many women fare better having devoted more time and
energy to exclusively grieving a lost infant (Forest et al., 1982);
but most do not take this path.
Research
literature frames quick re-engagement with the reproductive process
as a 'coping mechanism' (Gaudet, 2010; Wolff, Neilson and Schiller,
1970) with a risk of 'replacement baby syndrome' (Gaudet, 2010).
Pregnancy after loss may in fact be an added complication in an
already labyrinthine grieving process (O'Leary, 2004). It has been
found to dampen some aspects of grief, including the loss of
self-perception as mother, the loss of social role as mother, and
guilt (Lin & Lasker, 1996; Theut, Zaslow, Rabinovich, Bartko &
Morihisa, 1990).
Women
in online support groups almost universally agree that the decision
of when or if to have another child is a complex and personal one.
The very concept of 'rainbow baby' indicates that the mother may
currently be experiencing intense grief while also welcoming a new
child into her life. The belief that the next pregnancy should come
only after the first loss has been 'fully grieved' is one that is
found more frequently within the medical literature (O'Leary, 2004;
Côte-Arsenault, 1995) than the statements or actions of mothers
themselves.
And
yet, healthcare professionals continue to make that recommendation
(Gaudet, 2010; Forest et al., 1982). Such statements about the
morality of reproduction (who has a right to bear children, through
what means, and with what frequency) are often perceived differently
from the perspectives of a healthcare provider and a patient. An
assumption that women are persons with agency should lead healthcare
providers to facilitate women's choices instead of dictating them.
Therapeutic support for the vast majority of women who are pregnant
soon after loss is an ethical imperative.
Shibori
Healing Group Worksop: Overview
This
paper accompanies an eight-session workshop entitled 'Shibori
Healing: Textile-based Group Therapy for Mothers'. In this short-term
therapy, pregnant women who have previously experienced perinatal
loss are encouraged to discuss, learn about, and support others in
the various elements of the grieving process. At the same time, they
are encouraged to look forward to meeting and raising their new
child, to foster an attachment with him/her, and to consider how
their experience with loss will both present challenges and provide
special meaning to the process of raising a child.
The
workshop takes its cues from other support groups (Alcoholics
Anonymous, Mothers Against Drunk Driving) but asks questions more
often heard in interactional group settings, such as those of an
existential nature (Yalom, 2005). 'Shibori Healing' does not rely on
the agenda-like structures often used to facilitate support groups;
instead, it makes use of the long-standing tradition of communal
women's work. Shibori is an ancient Japanese cloth dying technique
which is process-intensive and yet easy to learn. With each workshop
session, participants are invited to learn and talk about suggested
topics while they work on their pieces.
While
the technique of Shibori dying does not have special significance to
this topic, the assigned textile piece connects intimately with
attachment and hope: participants create a baby-carrier for their new
infant. 'Babywearing' is both a traditional and contemporary practice
which has been shown to increase levels of bonding and attunement
between parent and infant (Johnson, 2010; Anisfeld, Casper, Nozyce, &
Cunningham, 1990). It is hoped that the act of creating a simple
carrier within a safe and supportive female community will foster
trust, self-confidence, and a feeling of belonging. The tangible
product produced at the end of the workshop may also be experienced
as an expression of the participant's growing confidence that the
child in-utero will soon be held closely within it.
Reflecting
the popularity of online support groups addressing all issues of
parenthood, 'Shibori Healing' also takes advantage of the advent of
social media. A private online discussion group specifically designed
for workshop participants will be made available, lightly moderated
on a daily basis by the workshop facilitator. According to statements
made online, mothers who participate in online groups designed to
support them through perinatal loss often experience them as
life-changing, in some ways more intimate than their relationships
'IRL' (In Real Life) (Evans, 2010). It is hoped that the online group
will provide another avenue for social support.
Shibori
Healing Group Workshop: Technology
People
who were once my friends have pushed themselves away because they
don’t know what to say, they don’t know how to act. Normal
activities like taking a shower, eating and driving to work are no
longer the same. But then, God sent me gifts...Friends who really get
it. Friends who understand how it feels. And although I would never
wish this upon anyone, I am elated to have met some of the incredibly
amazing women who have been sent to me...By forming these
exceptionally strong bonds with women I have never met, we are
honoring our babies. We are celebrating their lives and we are each
strengthened by one another (Evans, 2012).
The
rise of social media has impacted the normal process of grieving for
a lost child. While parents continue to face the challenge of social
awkwardness and even ostracism from their friends and family (Rando,
1984), they now have the option of participating in one of hundreds
of online parenting and grieving support groups. Many of these groups
have secondary affiliations through which parents can further connect
and receive support: religious beliefs, the age at which the child
died, or the means through which the death occurred. Participants are
encouraged to discuss the details of their child's death, the ways
they experience and cope with grief, and post pictures of their
deceased children.
Almost
all of these groups explicitly share the intention of supporting
members in their grieving process, helping them to feel that their
grief is accepted and validated.2
Stories of miscarriage, stillbirth and infant death are often greeted
with long comments of commiseration, transcriptions of prayers made
on the initial poster's behalf, and stories of healing from mothers
who have experienced the same. These new networks of support offer
help in the form of suggestions for burial rituals, trained volunteer
guidance, pen-pals and intangible, technologically-mediated human
comfort.
Shibori
Healing Group Workshop: The Value(s) of Cloth
Cloth, by its very nature and
function, occupies the transitional space between the boundary of the
self and the other, individual and social, private and public. For
the newborn infant, cloth literally becomes a secondary holding
environment, and the first experience of feeling mother; of comfort,
safety, and warmth… or lack thereof. For this reason, textiles
provide what Bion and Winnicott termed a ‘containing environment’.
In psychological terms it is this environment, usually created by the
parents, where the infant feels held by another (Kalaba, 2011).
The
practice of 'babywearing' has been shown to enhance attachment
between infants and caregivers (Johnson, 2010; Anisfeld, Casper,
Nozyce, & Cunningham, 1990). The carrier produced in this
workshop is simply a rectangle of cloth held together by two rings.
While participants will be encouraged to become acquainted with and
consider using the practice, babywearing itself is optional. The
simplicity of this carrier's design allows the cloth to be used for
other nurturing purposes: to swaddle the infant (which could help to
calm infants perhaps in extra needs of such containment, if their
mothers experience pre-natal depression, as discussed above); to keep
the infant warm; to reduce distraction during breast feeding if the
mother chooses to do so; and so on.
Traditionally,
'women's work' in the Western world has engaged with cloth, producing
textile-based objects imbued with psychological meaning. This has
been done through the communal and hands-on production of crafts,
clothing, and house décor. The modern stereotype of a mother
endlessly and endearingly attached to cloth items of special
significance, such as an infant's first outfit, may be seen as a
continuation of this tradition.
While
Winnicott (1957) first touched on the psychological importance of its
nurturing, corporeal nature, psychology as a discipline has shied
away from studies of cloth. The use of textiles in supporting people
through grief has been left to the exploration of community-based
projects, most often run by women who have themselves experienced
loss. Little Angels Hankies, in which a handkerchief is embroidered
with the name of a lost child and then sent to the grieving family
free of cost, is one example. Collecting Loss, in which family
members contribute clothing worn by a deceased loved one for public
exhibition is another.
The
use of cloth in 'Shibori Healing' is an effort to continue this small
body of work. It is hoped that engagement with textile production
will help participants to deeply and tactically engage with the
concepts most difficult for mothers who have suffered loss: the felt
sense of being a mother; the urge to both create and inhabit safe,
womb-like spaces; and the desire to hold a healthy baby in her arms.
Shibori
Healing Workshop: The Importance of Group
The
group format of this workshop was selected for a number of reasons.
The first is simple social validation: participants will be exposed
to others experiencing many of the same events (what Yalom (2005)
calls the 'principle of universality'). Through this, participants
experience a reduction in feelings of isolation and anxiety. The
second reason is community.
Historically,
Western women engaged in manual labour in close proximity to each
other. Time spent with close female kin allowed the transfer of
traditional knowledge (Gorer, 1949), especially with regard to
parenting techniques and values. Current cultural fragmentation and
industrial advances have made this forum all but impossible. The
proliferation of online mothers' forums demonstrates that modern
women need social advice-giving and support forums (both online and
in real life) more than ever. Lastly, the group format has been found
to be particularly helpful in addressing existential concerns (Yalom,
2005).
Some
theorists have posited that mothering an infant serves not only to
transform a woman into a mother, but also as a buffer against her
natural death anxiety (Taubman-Ben-Ari & Katz-Ben-Ami, 2008;
Deutsch, 1945). The experience of birth itself increases a mother's
access to her unconscious ideas about death (Westbrook, 1978). With
the loss of a child, the mother is thus forced to confront mortality
in a number of ways. Yalom (2005) explains that group therapy has a
special ability to deal with such existential issues, helping
participants to recognize that, “...life is at times unfair and
unjust...ultimately there is no escape from some of life's pain or
from death” (98). The chance to face these issues not in isolation,
but in a supportive group setting, could be helpful for grieving
parents.
Conclusion:
'Shibori
Healing' was initially intended to fit within the framework of
therapeutic expressive arts therapeutic, as put forth by Paulo Knill,
Ellen Levine and Stephen Levine (2005). But in this workshop,
the visual elements of the cloth dyed and sewn are not considered the
expression of inner psychological workings. On further reflection, it
was understood that 'Shibori Healing' and perhaps therapeutic work in
producing textiles in general, speaks to a different understanding.
The production of textiles
almost always involves repetition and the fulfillment of a
predetermined design. In 'Shibori Healing', the emphasis is put on
repetitive, body-based tasks intended to allow space and time for
psychological transformations to occur. These transformations can
then be expressed and integrated in other areas of the client's life,
but are not likely to be evident in the patterns of the shibori cloth
itself. The product of this therapy is both functional and
relational: loss experienced in the past is carried forward, embedded
within an object that can also carry new life.
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1Throughout
this paper, the term 'child' is used to refer to foetuses, infants,
and small children. This usage is not intended to make a political
statement on the beginning of life or the value of reproductive
choices; it simply reflects the expression of women participating in
online forums through which much of the research for this paper was
conducted.
2The
willingness to respect the boundaries of group members, however, is
not universal. It recently came to light that a visual artist in
Louisiana had downloaded and edited pictures of stillborn infants
with words such as 'sexy' and 'best friends!' for her piece,
'Stillborn in th3 USA'. Though she had taken images from publicly
available sources, as most online images are easily downloadable for
the use of anyone who wishes to – the news was reacted to with
outrage, calls to news stations, and the eventual hacking of her
site such that it could not display her work. The level of rage
directed at this artist and her piece corresponds with the level of
support offered to women who have suffered loss.
