Gough Elizabeth, Giannouli Vaitsa
Department of Psychology, Mediterranean College-University of Derby, Thessaloniki, Greece.
Health Psychol Res. 2021 Jan 14;8(3):9178. doi: 10.4081/hpr.2020.9178. eCollection 2020 Dec 30.
As many as 45% of women experience birth trauma. Psychotherapists' knowledgeable insights are largely absent in literature, and therefore the objective of this research is to gain a comprehensive understanding of how psychotherapists in the UK experience the therapeutic process when working with women who have experienced a traumatic birth. Interpretive Phenomenological Analysis (IPA) was employed to examine the data coming from psychotherapists working with birth trauma. Three ostensible areas of focus were revealed: i) Hearing the story: discovering the altered-self, ii) Working with the story: enabling redemption of the altered-self, and iii) Professional challenges and the wider story: advocating for the altered-self. Birth trauma commonly leads to an altered sense of self, intertwined with a perception of loss regarding the birth experience and autonomy. Working with the client's birth story, to enable redemption and restore reasoning, is integral to the therapeutic process. Stabilisation and consideration of the presence of the baby are also significant. Integrating approaches produces positive outcomes. There is a purported gap in NHS services, professionals either lacking knowledge and misdiagnosing, or being limited by the emphasis placed on Cognitive Behavioural Therapy. For the therapeutic process consider: the sense of loss associated with the birth; working with the client's birth story to enable redemption and restore reasoning; the impact of the presence of the baby and the need for stabilisation; birth trauma as unique. For frontline health professionals: implementing existing screening protocols and undergoing training to recognise birth trauma may reduce misdiagnosis.
多达45%的女性经历过分娩创伤。心理治疗师的专业见解在文献中基本缺失，因此本研究的目的是全面了解英国的心理治疗师在与经历过创伤性分娩的女性合作时，如何体验治疗过程。采用解释现象学分析（IPA）来研究来自处理分娩创伤的心理治疗师的数据。揭示了三个表面上的重点领域：i）倾听故事：发现改变的自我，ii）处理故事：使改变的自我得到救赎，以及iii）专业挑战与更广泛的故事：为改变的自我发声。分娩创伤通常会导致自我认知的改变，与对分娩经历和自主性的失落感交织在一起。处理客户的分娩故事，以实现救赎并恢复理性，是治疗过程的核心。稳定和考虑婴儿的存在也很重要。综合方法会产生积极的结果。国民保健服务（NHS）服务据称存在差距，专业人员要么缺乏知识并误诊，要么受到对认知行为疗法的过度强调的限制。对于治疗过程要考虑：与分娩相关的失落感；处理客户的分娩故事以实现救赎并恢复理性；婴儿存在的影响以及稳定的必要性；分娩创伤的独特性。对于一线卫生专业人员：实施现有的筛查方案并接受培训以识别分娩创伤可能会减少误诊。
