Two weeks after my second miscarriage, I was lost, confused, and grieving. Typically, as a therapist, I have a good sense of where to go when I need support. But I was in unchartered territory. My grief and confusion only intensified when my dozens of weight-crushing questions had ambiguous answers.
 
Prior to becoming pregnant for the second time, I was scheduled to attend a training in Dallas. The topic of the training was learning how to lead a psychoeducational group based on the work Dr. Brené Brown presents in her book, Rising Strong.
 
If you haven’t read Rising Strong, here is a brief synopsis:
 
In order for us to live bravely, we have to expect moments when we crumble, when things don’t go the way we want them to. Those moments can feel devastating. We start telling ourselves stories that are often inaccurate and self-deprecating. But, if we become aware of those stories we are creating, and if we work with them (or as Brené says, rumble with them), we gain clarity and strength to try again. Some of the ways in which we rumble with these stories include exploring grief, anxiety, shame, vulnerability, trust, and setting boundaries. By exploring how these concepts play a role in the story we are telling ourselves, we can pick ourselves back up.
 
As a Certified Daring Way Facilitator (someone who is certified in Dr. Brené Brown’s work on shame and vulnerability), I was eager to attend a training and potentially distract myself from our pregnancy losses. I always found professional development a great form of self-care. I was unaware, however, that this training would also lead to personal development.
 
I entered a room with ten other women. I had previously worked with the facilitator, and she greeted me with a warm smile and a hug. I took my seat toward the back of the room. My husband texted me, “Have a great first day of training!”
 
The Story I Can’t Stop Telling Myself

We create stories all the time. We think millions of thoughts a day, many of which are off-the-wall, or lacking any evidence. They are simply thoughts. But we don’t often realize that. Sometimes, the stories we tell ourselves start to define us. When we start to believe our thoughts, we start to feel shame.
 
The Rising Strong process starts with you writing down the story you can’t stop telling yourself. By writing down your thoughts, you become acutely aware of their presence, rather than having them fill up in your brain, leaving you to wonder why you are feeling so sad/anxious/unhinged.
 
Examples of some of the stories people with pregnancy loss tell themselves include:
 
I’m not meant to be a mother.
I’m a failure as a wife.
No one understands what I’m going through – I must be making this all up in my head.
Why can’t I just get over this? Other women do.
Am I being punished for something?
Maybe I am really screwed up.
I can’t keep a child safe, even before she is born.
 
No wonder we experience deep shame after a pregnancy loss.
 
Beginning to Rumble: Shame
 
After identifying your story, the Rising Strong process has you rumble with the emotions embedded in your story.  
 
The first big emotion: shame.
 
Brené Brown defines shame as: “The intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.” It translates to us saying to ourselves, “I’m not enough,” or “I’m too much.” In recurrent pregnancy loss, those can be:
 
 I’m not woman enough.
 I’m not a good enough wife.
I’m not deserving to be a mother.
 
It could also be:
I’m too fragile.
I’m too weak.
I should be over this by now.
 
Brené Brown writes, “You can’t engineer an emotional, vulnerable, and courageous process into an easy one-size-fits-all formula.” I remembered a book I picked up shortly after my first miscarriage, a book with a title that promised me I would be healed from the pain of my miscarriage in 30 days. You may or may not feel healed after 30 days. By promising a prescription that not only has no evidence supporting its efficacy, it is incredibly misleading. What happens when the prescription does not work? We personalize it: What’s wrong with me that I can’t be over this in 30 days, when I was promised that this would work! This only intensifies our shame and our feelings of unworthiness.
 
In pregnancy loss, we are not just experiencing that shame as it relates to our identity, but we might also be shaming ourselves for the grief we experience. Grief is not linear, and grief does not have a timeline. Grief does not promise that we continue to feel better over time, consistently. Rather, there are days when we feel better, and there are days when we feel worse. By normalizing this grief process as an individualized experience, we can potentially reduce some feelings of shame.
 
Rumbling with Grief
 
In Rising Strong, grief is defined in three ways: loss, longing, and feeling lost.
 
Understanding loss was straightforward: I had lost my second baby. Longing, however, was not something I had considered prior to the workshop. Longing is defined as “an involuntary yearning for wholeness, for understanding, for meaning, and for the opportunity to regain or even simply touch what we’ve lost.”
 
Women and couples who experience pregnancy loss grieve losing something that was not yet breathing, someone they had not yet held. They grieve the loss of an identity (mother or father), and the loss of creating the family they had so hoped to create.
 
Brené Brown defines this type of loss as ambiguous grief. Ambiguous grief is different from other types of grief in that we have lost something or someone that is either still alive or was never born: divorce, job loss, ending a dear friendship, and pregnancy loss. We don’t often know how to respond to this type of grief, because it typically isn’t honored in our culture. We don’t allow for the time and space to heal from this type of loss.
 
Feeling lost generally accompanies grief, in that grief requires us to reorient ourselves. After a pregnancy loss, we are reorienting our bodies physically by being pregnant to suddenly not being pregnant. We are also reorienting our plans, hopes and dreams. I had to let go of the plans I had made for my babies to arrive in this world. The next year that I had mapped out was now erased. I went from being an expectant mother to a recurrent miscarriage survivor. How do we reorient ourselves after that?
 
We reorient ourselves, gradually, by mourning.
 
 
The Conclusion
 
As we neared the end of the workshop, the facilitator instructed us to do something that honored our grief. I wrote a letter to my unborn babies, and hold a small memorial service for them.
 
It was a warm, sunny January day in Dallas. I removed myself from the group to complete this exercise outside. I sat on a bench in a garden, underneath a willow tree. Birds were singing. It was the perfect spot for a memorial. I expressed my love and gratitude to my babies, and I cried. A real, deep, cathartic, cry.
 
When I returned back to the group, we looked back at our original story we were telling ourselves. And we began rewriting them. My story went from a shame-filled, demeaning, degrading tale, to the following:
 
I feel sad I can’t give my family what we want. Being pregnant allowed me to feel hopeful. I felt connected to my partner. Just because I feel failure does not make me nor my body, by definition, a failure. I can honor my grief and my pain, and I can trust that I am not alone in that.
 
By rewriting our stories, we are not hiding our pain. We are acknowledging it and holding it up, free from shame, and full of self-compassion. This acceptance doesn’t mean that you have wiped away pain; rather, you have accepted the event, and the deep hurt, and by doing so, providing your grief an outlet. Acceptance means we are rumbling with our grief, and not turning to shame.
 
This doesn’t mean that trying again isn’t hard. In fact, after a pregnancy loss, there is immense strength in saying, “let’s try again.” The courage to try again doesn’t mean we don’t feel fear. But, by returning to the Rising Strong process, we feel the courage to do so. As Brené Brown says, “We are the brave and brokenhearted.”  

For more information on Rising Strong, by Dr. Brené Brown, visit her website: www.daretolead.brenebrown.com.

There are countless resources available to us in our wellness, mental health journey. Here is a list of some of the books that have shaped my therapeutic practice, both personally and professionally.
 
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Bessel van der Kolk, M.D.
 
This book is a wonderful exploration of trauma, and a resource for ways in which all of us carry trauma, anxiety, and depression physically around with us. Dr. van der Kolk is the founder and medical director of the Trauma Center in Brookline, MA, as well as a professor of psychiatry at Boston University. His work explores war veterans, children of alcoholics, and survivors of domestic and physical violence. Trauma impacts our ability to experience pleasure and engagement. This book is a resource for navigating healing trauma, and understanding the mind/body connection.
 
The Gifts of Imperfection. Brené Brown.
 
Granted, all of Brené Brown’s books are incredible reads! What I love about The Gifts of Imperfection is the step-by-step process she outlines for us to challenge our self-identified perfectionism, and find ways to truly and fully live into who we are and become our true selves.  This book celebrates being you!
 
Deeper Dating. Ken Page
 
Right now, dating apps are encouraging their users to connect with potential dates remotely. These apps are taking a very active stance in following the shelter-in-place guidelines. Your dating life does not have to come to a complete end! Ken Page, a fellow New York City psychotherapist, has developed a wonderful guide to dating in the modern era. Unlike other dating books, Page encourages the reader to first identify their “core gifts” or their values. It allows for wonderful reflection and self-identification, that strengthens our future connections with potential dates.
 
 
Self-Compassion. Kristin Neff
 
We use a lot of terms in this work, oftentimes without ever really explaining them! Trust, integrity, empathy, values, and self-compassion. I love Kristin Neff’s work because she clearly defines what self-compassion is. A researcher and associate professor at the University of Texas at Austin, Neff has defined and revolutionized the ways in which we speak to ourselves, soothe ourselves, and show ourselves the love we all deserve. She has created a Self-Compassion Scale, an evaluative tool that is available on her website (www.self-compassion.org). This scale allows you to identify specific areas to target improving your self-compassion. She also defines three core components to self-compassion: mindfulness, self-kindness, and common humanity. Mindfulness is the act of being present. Self-kindness is speaking kindly and gently to ourselves, as well as doing kind acts of service for ourselves. Common humanity is the understanding that we are all in this together: suffering is a universal experience. Her book, as well as a companion workbook and activities on her website, provide us with hands-on ways to practice self-compassion every day. Her work is so relevant that mental health professionals in various differing disciplines site her work. A must read!