How to manage harm thoughts?

 
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A brief note on seeking support

For more info on help-seeking options, please scroll to the bottom of this page. In this subsection I also offer resources supporting you to talk to your GP about your unwanted harm thoughts.

1.   Understand why intrusive thoughts occur

What can help is to understand these kinds of thoughts as normal. You are normal. They are understandably distressing but we know that the human brain is often overflowing with all sorts of thoughts and imaginings. Some of these we choose while others simply arise seemingly out of nowhere. Consider the normal experience of intrusive thoughts for a moment, unrelated to a new baby. Have you ever stood on a train platform and experienced a sudden urge to push someone onto the track? Or been on a high balcony and imagined throwing yourself over the edge? These kinds of thoughts, images, urges and impulses pop into our mind for many reasons, and are completely normal for both adults and children (Cree, 2015).

Why do they occur? Because our minds have evolved to keep us alive and safe.  From the age of early hunter-gatherers, whose key concerns were survival and reproduction, the primitive mind was constantly assessing the environment for danger – and striving to avoid it. Our ancestors developed a ‘better safe than sorry’ approach: when out hunting, they may have fled when they didn’t need to, but they survived. Now the modern human mind has become increasingly skilled at anticipating and avoiding threat.

Designed to ‘look out’ for danger, the modern brain generates thousands of thoughts many of which flow beneath our active awareness (in the unconscious mind). But from time to time, when a harm thought about our baby evokes an emotional reaction such as fear, guilt or shame, this triggers your internal alarm system, shifting the thought into consciousness. It’s our brain’s ‘better safe than sorry’ principle in action: to alert you to the potential threat. This allows you to do something about it, say by finding solutions to help keep your baby safe. However, our brain can’t distinguish between real life-or-death threats or imagined horrors. This means that the ‘fight-or-flight’ response kicks in, whether in response to an attack by a wild animal or an internal threat such as a harm thought. Either way we are flooded with adrenalin and fear, with a powerful urge to flee or fight to survive.

2.    Understand the intense emotions around harm thoughts

My research highlighted how harm thoughts are often accompanied by a powerful emotional experience. The women I spoke to associated their thoughts with an overwhelming lack of control, with harm thoughts sometimes “popping up” seemingly out of nowhere. This experience, combined with the chaotic, overwhelming nature of early motherhood can understandably, be distressing and anxiety-provoking for new mums. So it can help to recognise these thoughts as occurring as part of the adjustment to the enormous responsibility that comes with a new baby.

The women in my project also described the complex, double-edged nature of their new responsibility: a sense of their own or another’s power and acute awareness of the vulnerability of their baby. 

“…I suddenly had the realisation that I could pinch him if I wanted to, like it was kind of testing the boundaries of the power I had over him…‘cos in the early days they don’t really feel like a person.” HANNAH

“My little girl’s vagina was in front of me, and thinking how small it is, and thinking how innocent this baby and child is, and how anybody could even go there, or touch that inappropriately…”  POLLY

This means harm thoughts can be understood as helping mums work out clear boundaries between what is morally acceptable and what’s not – serving as an “effective warning system” (Stadlen, 2004). Such vivid images or impulses can represent natural fears that the baby might suffer or die through carelessness or inadvertent neglect, helping mothers stay alert. My research participants learnt gradually over time how to protect their babies, learning to tolerate their anxiety to help them to grow more confident in their positions of power.

Now you understand more about the complex emotional reaction to harm thoughts, what you do next in response to them is important...

3.    Don’t push away or avoid the thought.

It is understandable that feeling distress in response to a harm thought, makes people want to avoid or get rid of the thought. Surely, ceasing to conjure these imagined baby-related disasters means pushing them away in our minds. Or perhaps even avoiding doing certain activities with the baby, such as bathing them, if that scenario triggers harm thoughts. Unfortunately, pushing away or avoiding these kinds of thoughts has the opposite effect: it increases their power and intensity, so that they keep coming back to you more and more.

To illustrate what avoiding the thought does, try this little experiment for a moment – created by psychology professor Daniel Wegner at Harvard University. For the next 30 seconds, try not to think about white bears…… Don’t think about what they look like…… the colour or texture of their fur….their size… Just don’t think about them at all.

So how did that go? Exactly – I bet you couldn’t stop thinking about white bears. It’s something that research robustly shows – suppressing a thought only makes it rebound again… again and again. This is because one part of the brain avoids the suppressed thought, yet another part goes into monitoring mode, scanning for the presence of the suppressed thought (viewing the thought as a threat). So what comes to mind? The very thought you want to avoid.

4.    Interpreting harm thoughts… they don’t mean you’re a ‘bad’ mum

If a harm thought appears seemingly out of the blue, and you understand it as purely a thought - a random mental event that you became conscious of because it made you feel anxious or afraid, then you’re more likely to be able to notice it... then let it go. However, for many new mums juggling other challenges around early motherhood, such as losses to identity, the body and relationships, this isn’t so easy. Of course it’s completely understandable to feel a sense of horror, upset or disgust in response to an intrusive, unwanted imagining of harm coming to your precious baby. But as my research and clinical experience shows, new mums often interpret their harm thoughts to mean something bad about them as a mother. This makes it harder to dismiss the thought and let it go.

So why do thoughts of accidental or deliberate harm to our baby make us feel like ‘bad’ mums? My study found that it has a lot to with the ideology of motherhood prevalent in Western culture. This powerful societal myth depicts women as ‘natural’ mothers, instantly able to care for their babies and ultimately fulfilled in their cheerful sacrifice (Ussher, 2006). It’s not our fault that as women we’ve internalised this myth of motherhood  (‘internalise’ refers to the way in which beliefs we are exposed to growing up shapes our internal ‘voice’ - and in this case, the kind of mum we aspire to be). ‘Supermum’ images surround us from early on, exemplified by the elated Madonna in churches, and appearing in fairytales and Disney films extolling the ‘happy ever after’ of marriage and motherhood. The myth is pervasive, continuing to bombard us through the media. Via curated Insta-feeds of sun-kissed celebs for example, showcasing babes breast-feeding from beach-ready bodies… all just weeks after childbirth.

Feminist psychologist Paula Nicolson (2001) suggests the ‘Supermum’ myth is tied to patriarchy’s romanticisation of motherhood, as a means of oppressing women. This myth holds power as it sets the standard for what is a ‘good’ mum (and therefore a good woman) – and what is a ‘bad’ one. It places huge pressure on women to live up to this cultural ideal. This myth has been shown to shape women’s expectations of motherhood (Mauthner, 1999). It leads to mums believing they must prove to themselves and the world that they are calm, coping, loving their new role and in control at all times. Sound familiar?

And yet, when we experience the reality of having a baby, we discover how living up to this ideal is impossible – setting women up to fail! Overall, this powerful myth makes it hard for mums to express any dissatisfaction or ‘negative’ feelings about motherhood without feeling inadequate, guilty or ashamed about being judged a ‘bad’ mother.

The ‘Supermum’ myth influenced all my participants’ own internalised notions of ‘good’ and ‘bad’ mother – and then how they made sense of their harm thoughts. For some, harm thoughts produced conflict when the myth clashed with their lived reality – leading women to pathologise their thoughts as ‘mad’, ‘bad’ or ‘dangerous’ in order to maintain their ‘good’ mum identity.

So how to manage all of this?

a.     Recognise the myth of motherhood. First, try to reflect on how the ‘Supermum’ myth may have impacted your own experience after having your baby. Did you experience a harsh gap between expectation and reality, and feel unprepared for becoming a mum? Do you notice feeling distressed or ashamed around ‘negative’ experiences such as harm thoughts because they don’t fit the joyful norm? This will help you to make sense of where your thoughts may be coming from, empowering you to actively resist this myth.

b.      Actively resist the ideology. This means becoming gently aware of cultural pressures on modern mothers to live up to the ‘Superwoman, superwife, supereverything’ mum - who must cope, deny offers of help and hide their true feelings (Choi, 2005). Becoming more aware of the myth can help you to give it less power. It gives you more space to respond differently to the ‘shoulds/ oughts/ musts’ tied to the ‘perfect’ mum ideal. Instead, try to develop a more compassionate internal voice. Start by letting yourself off the hook of parenting a ‘right’ way, telling yourself – even if you don’t believe it at first – that you’re ‘good enough’. The more we can learn to accept the paradoxical nature of motherhood – as both magical and tiring and tough – the more women can be encouraged, and encourage each other, to voice negative aspects without fear or shame.

Some of the women I interviewed were able to resist the ideology to manage distress when experiencing the myth-reality gap. They could understand their harm thoughts as arising out of a particular context (e.g. stress and sleep deprivation), without attaching significance to what harm thoughts meant about them as a mother. Over time, they came to accept their thoughts as normal. This was still an intense emotional process but it meant that they learnt not to interpret their harm thoughts as indicating maternal badness.  

To help you manage a harm thought when it next appears, develop self-soothing statements. For example, you can say: “Hello there, harm thought. You are simply a thought. This experience doesn’t mean anything bad about me. I am doing ok. I am a good enough mum.”

5.   Practice mindfulness skills - allowing harm thoughts to come and go.

Learn to notice these thoughts and to let them come… and go. This means practicing skills of mindfulness to acknowledge and notice a particular harm thought, showing awareness of the thought with kindness and without judgement, and then trying to let it go.

For those unfamiliar with mindfulness, this means paying attention in a particular way…on purpose… in the present moment… without judgement (Kabat-Zinn, 1994). This can be hard to do in practice, as our thoughts tend to focus on our plans or what troubles us. These concerns often pull us into the past, or the future – and out of the present moment. Mindfulness is not about clearing your mind! It’s training yourself to be self-aware. Aware of what’s happening NOW: in the present, moment by moment. Not making judgements about what you find. Sometimes described as taking an ‘Observer position’, this allows you to step back from the thought, to hold it at arm’s length as it were, giving you time to decide how to respond.  

When experiencing a harm thought about your baby, you can also practice becoming aware of the feelings that come with it. As well as noticing the thought, try tuning into your body for a moment. What else do you notice, what sensations can you feel, what emotions are present?

Come back to the breath

After observing your feelings, try to come back to the breath. Returning to focusing on your breath is choosing to come back to the present moment, again... and again. Try breathing exercises and progressive muscle relaxation to help you calm any anxiety and distress that comes with an unwanted harm thought.

6.   The power of normalising – talk about your harm thoughts with others.

None of the women in my study shared their harm thoughts with a healthcare professional. Even those who spoke about them to a partner or friend(s) limited what they shared. Why? Because some women felt shame and guilt around the thoughts - fearing being judged a bad mum for sharing something deemed unacceptable.

This meant women self-censored what they shared with others due to real fears of being judged unable to cope (i.e. failing to live up to culturally idealised ‘Supermum’). Ultimately, they feared having their baby taken away.

“There were times when I felt like calling a Helpline and saying there’s something wrong with the baby. But then I was very worried about going to a doctor, or a hospital, and I was very worried that they would step in, and take over, and say “She can’t cope, we’re going to take him away’. My worst fear down the line was that they would take my children away from me, both of them, because I couldn’t cope.” SALMA

However, those women who felt able to share their harm thoughts with family or friends spoke of the enormous power of normalising – through sharing.

“Yes, yes…she said she’d had them with all three of her children and as soon as she said that I thought ‘Oh! Thank god!’ I know it’s a horrible thing to say, but I just thought ‘Thank god somebody has said it. Thank god she’s being open about it’. I needed somebody to be frank. And then I didn’t feel like a bad mother then. I felt like somebody cared enough to tell me, and I thought well I want to share my feelings as well.” SALMA 

“Yeah, and in all the things I’ve read I’ve never come across this unwanted impulse thing, and actually if it is common, it probably should be something that’s talked about. Because not being able not being able to talk about it means it becomes a bigger deal.” HANNAH

 The women I spoke to had recommendations for other mums experiencing harm thoughts:

 “I’d tell her it was normal, it had happened to me…I’d just think everyone has it because it’s hard being a mum and you don’t really know what you’re doing most of the time.” MALIA

 “…And sort of try to help them, that it doesn’t mean something about them as a mum having a thought like that.” KAYLEIGH

7.   Learn to parent yourself

Just as you sit with your child’s distress, hear and soothe their fear, try to learn to do the same for yourself. Be kind to you. Work out what helps you feel more connected to yourself: is it getting outdoors amongst nature? Physical exercise to release natural endorphins? Seeing a friend? Cuddling your baby to release all that lovely oxytocin? Singing in a choir or karaoke? Lying in a darkened room wearing an eyemask? Having a bath? Growing a plant?

Certain activities will naturally suit you better at different times. Work out what works out for you in any given moment, and try to build it in to your life, step by step. And remember, change happens over time, so be kind to yourself. Don’t beat yourself up if you don’t do what you set out to do that day… take each day as it comes. And remember: you are good enough.

8.   Seek professional support

Please note: this website is not therapy. If exploring your harm thoughts feels too difficult or scary because, perhaps, having a baby has stirred up painful memories linked to traumatic or difficult earlier experiences, please talk to someone you trust and/or seek professional help.

If you’re struggling to manage these thoughts, I would recommend talking to a trusted loved one, your Health Visitor if you have a good relationship, or requesting your GP refer you to a local NHS Psychology service.

9. Resources if seeking professional support

Sometimes it can feel hard to communicate these kinds of thoughts to a health professional. This can feel particularly hard given what we know about mums fearing they might be judged negatively, or unable to cope, or even have their baby taken away.

If you want to ask your GP about accessing more support, say talking therapy, at your 6-8 week check or at any other time, I offer ideas below for how you can prepare for your appointment:

  • Decide yourself or a with a supportive loved one what you want to say about your experience of unwanted harm thoughts about your baby (e.g. consider 1 or 2 examples of these thoughts/ images/ urges you can give, and feelings that come with it).

  • You can even ‘rehearse’ what you might say with your safe person.

  • Read the document I’ve posted below. It’s a published leaflet about intrusive, baby-related harm thoughts by a psychologist aimed at health professionals, who may have limited understanding/ training around these thoughts.

  • When you talk to or meet with your GP, tell them about your experience of unwanted thoughts as you’ve prepared.

  • Tell them you’ve read about these kinds of thoughts on this website, and show them the leaflet (linked below).

  • Tell your GP you’d like to access therapeutic support from a local Psychology service, ideally one offering perinatal support. Ask them what’s available in your area, discuss the available options and the possibility of referring you if you think it would be helpful.

  • DOCUMENT - a leaflet about unwanted, intrusive thoughts of harm about the baby aimed at health professionals. You can take this with you to your appointment with your GP or any health professional.

If you would like to get in touch with me, please contact me via link below:

Further help and advice offered here:

FREE Pandas UK Helpline (call Monday - Friday between 10am - 5pm): 0808 1961 776

http://www.pandasfoundation.org.uk/

Samaritans: call 24/7 Helpline: 116 123

https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health

https://maternalocd.org/

https://www.rcpsych.ac.uk/mental-health/problems-disorders

If you do have an overwhelming sense of wanting or intending to hurt yourself or your baby (e.g. if you are feeling so low or that you’re in such a dark place that this seems like the only answer), it is essential that you seek help immediately.

 If you’re worried about yourself in this way:

·      Contact your GP

·      Contact your GP out of hours service

·      Visit your local A&E or call an ambulance

·      Get a family member to join you if possible

·      Contact your local crisis team