When I started out in Private Practice at the beginning of this year, I couldn’t have foreseen what was coming. I was, I admit, a little naive, ‘breastfeeding probems? yes, I can help, I’m an IBCLC!……there’s breastfeeding solution to every breastfeeding problem!” So yes, on the one hand ‘fixing’ breastfeeding is what we do as IBCLCs, but it’s very much just the tip of the iceberg, one part of the big picture and it can’t be addressed in isolation. Because when we start to talk about and explore breastfeeding, we talk about the pregnancy, the birth, a mother’s expectations of herself and motherhood, sometimes her feelings about her body, previous experiences of breastfeeding, her close personal relationships, her family, her history.
I’ve gained a huge amount of experience since I started – twins, relactation, low milk supply, laryngomalacia, tongue tie, more tongue tie, breastfeeding after breast reduction surgery, prematurity, vasospasm, insufficient glandular tissue, and of course bucket loads of sore and cracked nipples. It has been a challenging, fascinating, and rewarding journey. The learning has been huge. But there has been another type of learning happening for me along the way and I’m only beginning to get some insight and clarity now on that journey, and I hope I can find the words to explain what it has entailed. What I have found in my work thus far is that one very significant aspect of the role of the IBCLC in private practice is holding space for the mother, or some cases both parents. Very often we see them at a time in their lives where emotions are raw and they are at their most vulnerable. They may be reeling from the shock of suddenly having become parents, or reeling from a particularly difficult birth experience. Sometimes they are experiencing trauma as a result, and in some cases mothers will be suffering from PTSD which is related to her baby’s birth. Quite often, the IBCLC who comes to a parents’ home in the days or weeks after the birth, will be the first person who has been able to sit down and spent two hours listening to that parent, hearing their story. Infant loss has featured quite a lot more for me in my work than I would have expected – I’ve seen several ‘rainbow’ babies and have had a few babies whose twin died in utero. Just this week, I spent time with a client who described to me how her 45 minute old baby died in her arms. I feel privileged to hear these stories and always have a sense that this is what I am meant to be doing – being in that role where I listen, support, help, hold space, facilitate a flow of emotion and sometimes grief, empathise, be the empath. And this aspect of my work is something I’m only beginning to understand. And I’m in a process of figuring out how I mind myself and keep myself strong and avoid burn out. I don’t know that I have it completely sussed, but for now what I’m finding is working is acupuncture every few weeks, occasionally debriefing with a colleague and allowing myself to ‘feel.’ Prior to starting in Private Practice, I would have assumed that to be professional would have meant the ability to be detached, to not show emotion, to not cry, to not share my private stuff, to not let myself take on the clients’ pain and to protect myself. But I’m finding that the reality is more of a gray area and that what is working for me is somewhere in between. Sometimes I cry with a mother. Sometimes I cry when I get into my car after a consult. And sometimes I feel a red rage over how a mother has been treated in our healthcare system. But I’m ok. I feel strong with this because I’m allowing myself to process what I’m experiencing with my clients. A kind of a parallel processing.
“As therapists, we are taught to maintain clinical distance – no personal items in the office, no self-exposure, no personal interchange (like gifts or cards) at holiday time, etc. It’s a nice idea, but, the truth is, we are human and so are our clients – that’s one of the reasons that people who are in this profession are in this profession, and one of the reasons that people needing support and guidance seek us out. Boundaries are necessary, but, by necessity, they are also fluid. This is the nature of human relationship.” (https://www.psychologytoday.com/blog/enlightened-living/200901/the-me-in-you-parallel-process-in-psychotherapy)
The idea that boundaries are fluid really resonates with me. We are all growing and evolving with time, but I think even more so when you’re working closely and one-on-one with people, hearing their stories and holding space for them as they articulate and explore pain, grief and difficult emotions. This is certainly my experience in my work so far. It has been a time of huge personal growth which has been facilitated (and continues to be) by ongoing reflection on what I do, openness, acceptance and an awareness of the necessity of self-care.
I did learn the hard way though. At one point I did let myself get too busy. I said yes to everyone who called. And I suffered as a result. I was convinced I was in the throes of the perimenopause – anxiety, insomnia, lack of appetite, and in general and edgy sort of feeling that I couldn’t seem to shake. So I took a step back. Started doing a little less work and making a conscious effort to make space for myself. That meant dragging myself to the odd fitness class in the local gym and seeing a wonderful acupuncturist (Gillian Searson in Sandyford) who helped me feel strong, more solid in myself and a whole lot calmer. I’m actually not experiencing perimopause at all – I was just stressed and I couldn’t see it! I wasn’t allowing time for reflective practice in relation to my work and I think the healthy flow of emotions (a parallel procesing) wasn’t happening.
I hope I’ve made some sense here. Even just a little bit. It’s my attempt to understand what I do. Who I am.
Caring for Ourselves when Caring for Others: What Lactation Consultants need to know about Compession Fatigue by Kathleen Kendall-Tackett https://connect.springerpub.com/content/sgrcl/4/4/137.full.pdf