Mindset Skills You Can Use

Mindset includes Central Nervous System Controls, the Relaxation Response and Mindfulness Meditation

Practicing a form of Mindful Breathing

There's so much going on for so many of us, and I've realized the work I do might be worth sharing I've decided to write a series on the Mindset aspect of my work as a wellness professional and childbirth educator. Before you scroll past this if you're not on the pregnancy and birth journey, know that this is one for all of us. Please enjoy a little taster of information that can be a tool in your daily toolbox of life. Think of my discussion of birth info as a case study, as birth can be at once a peak experience, something that feels very natural, for some something very filled with apprehension/anxiety/fear, something beautiful, truly a miracle, or, at the very least, for most birthing folks, a big day they will remember for the rest of their lives (this has been studied, so if you've been told "you'll forget it all," know that's not entirely true for the majority of people.). Enjoy this little case study topic and then we'll talk about applying it to any Journey of Life or Time of Transition. For today, I've included some information on Mindfulness and the Relaxation Response. I'll try to get into more of it next time.

Imagine how lovely it would be to feel "Calm, Confident and in Control," (in control of the "controllables," aka your Mindset, attitude and behaviors!) or "Calm and Comfort" as you go about your day. In other words, when you tap into the power of the Relaxation Response and other Central Nervous System Controls you can bring out your best because you're in a headspace where you can make better choices.

When we're freaking out, we tend not to make good choices. Let me own some examples from my own life. Driving to get my curbside veggie pick-up yesterday, I was driving on the turnpike and a pedestrian was on the shoulder of the road so I signaled and moved out of the right lane after checking my mirrors and blind spots and all that jazz, having already noted that the driver behind me was tailgating even though the left lane was clear. Dude suddenly decided he would also like to occupy that left lane space, the space where my car was and he nearly hit me. I breathe, check the pedestrian, signal, prepare to return to my comfortable, speed limit abiding right lane and Dude swerves in right behind me again. And now it just felt like an attack for whatever reason. I flip him off and cuss a blue streak. So, not my best moment. NOT a mindful moment, not a Relaxation Response moment. Was grateful for a moment that we're in a pandemic and so my kids were not in the car with me. As this was, rather, a Stress Response moment, a Panic Moment, Fight/Flight/Freeze Adrenaline Response moment, a panic/fear/why-does-Dude-want-me-dead moment. I will own this. (And Dude, I realize flipping you off was not a helpful move for either of us. I do hope you make better choices around safe driving distance and speed limits in the future and I acknowledge my own lack of responsible behavior in cussing you out and flipping you off. We're both human and so was that pedestrian I was trying to keep safe by moving over. Yeah, I'm still a bit salty about it, it seems, I'll work on this.)

When I DID engage in SLOWING DOWN, breathing and taking a moment to decide my next move instead of knee jerk reaction was later on yesterday when I stepped on a piece of glass. "Ouch, what is that?" I took a breath, investigated, "Ok, that's a piece of glass." I removed the glass, washed the wound, threw the glass in the trash, hobbled to the bathroom for a band aid, re-washed the wound, bandaged myself, and tenderly got on with my day. I didn't cuss out the glass or my foot. I was able to make better choices because I stayed calm. (This approach also works wonders when dealing with pandemic-restricted children who may be a bit salty about, oh, say, just about everything, note the breathing exercise below. Know I use this frequently at home, even more so in the past 9 weeks or so than usual. Know that it also works great for the kids to use it, if, say, it's an idea coming from TikToc or something instead of, you know, a parent who teaches this stuff for a living. Say, anyone under 20 want to put up a TikToc on this? Pretty please? Just sayin' better choices for all sounds like a good plan.)

As a childbirth educator, I often teach programs that include information on comfort in labor and birthing, a time that can be a peak experience for many, or a time of sheer terror, especially for the unprepared and unsupported. So, part of my work is to increase knowledge of the process of birthing, knowledge of how support and decisions the individual makes can impact their birth experience, and help folks find ways to "stack the odds in their favor" or the birth experience they are hoping for. In my work, this includes training on advocacy, evidence, decision-making, hands-on comfort skills and mindset skills for the birthing parent and their primary birth support person.

I want you to take out a piece of paper and pen or open a notepad sort of thing on your device and get ready to write the first 5-10 things that come to mind when you read the first word in the next paragraph. This will be a fun thought experiment, and I promise I will pull this all together before the end of this piece. Go ahead, get ready.

Birth. If you grew up in the US or a similar culture, the idea of giving birth is aligned with a mix of "fear," "blood," "pain," "shouting," "screaming," "epidural," perhaps "a miracle," maybe you're one of the few (yes, this is true) who thinks of the word "birth" and then associates it with "baby," and, whatever you're thinking about, I'll bet that of the last five film or TV depictions you've seen related to someone actively giving birth (unless you're a birth educator, and maybe even then), you've seen at least three that included screaming/shouting, probably a partner freaking out or doing things as though they'd suddenly become incapable of rational thought, some indication of a need to rush, or an emergency scene, or that someone needs to find something to tie off or clamp the umbilical cord (for the record, this is NOT necessary and can cause harm, so if you're ever there when someone gives birth unexpectedly, even as a first responder, without a midwife, family doctor or OB handy, know that you can just leave the cord attached to the placenta until one such qualified care provider arrives on the scene). If you grew up with scenes of birth where someone was shouting, or screaming, or their water broke and they had to rush to their birthplace because "baby's coming!!!!" then you, like most of us, are basically "brined" in an unrealistic view of what birth is and how it happens. These "beliefs" about birth grow more powerful every time we see this story repeated, reinforced every time someone tells their story about pain, screaming, something scary around birth. For those who have had those experiences, there is an injustice in our culture that we don't hold space for folks to discuss their stories and experiences*. I also believe that it is an injustice when folks are not given the tools to reframe the concept of birth into "peak experience," "amazing," "bonding with partner," "beautiful," "like moving mountains is possible," "positive," or even just plain "a good day." It is a lot to retrain ourselves, to change the stories that run on autoplay in the background in our minds every day. This is true for any of us, pregnant or not.

As the first GentleBirth® instructor in the tri-state area, I've now spent years teaching folks how to reframe "labor pain" to "sensation," something in and of itself neutral. Using the mindset skill of Mindfulness, learn to experience sensation as a neutral that gives us additional information. We also look at how pain itself is processed in the brain, and the perception of the intensity of pain is correlated to the amount of risk of injury or danger our brain perceives in any given situation. So, once that is discussed, we are able to break the connection, in the brain, using evidence-based mindset skills, between contractions of birthing = pain and reframe the contractions/waves/surges as sensations rather than pain. All this is to say that I tend to use the word "sensation" rather than "pain" to discuss contractions in birthing.

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Rebecca Dekker is a nurse with her PhD, a background in research and teaching adult learners, and founder of Evidence Based Birth®. She has developed many programs and resources for parents and professionals, one is "Comfort Measures for L&D Nurses," another is the "Pocket Guide to Comfort Measures in Labor & Delivery." (If you know an L&D nurse, these would make GREAT gifts, by the way.) In the Pocket Guide three "mechanisms for pain management" in labor/birthing. They are: Central Nervous System Control, Gate Control Theory and Diffuse Noxious Inhibitory Control. The first of these is what I'm going to talk about in this piece as it connects to Mindset.

Examples of Central Nervous System Control include Meditation, Relaxation, Hypnosis, Aromatherapy, Music and, in birthing, Doula Support. These are all evidence-based practices during birthing, by the way, when used appropriately and with proper training. Of these, you can see that almost all can be applied to our daily lives. In fact, many of us have someone serving in a doula-like capacity, someone who is an expert in their field and ready to give us the individual support we need as we travel through a transitional or need-to-learn-a-new-skill portion of our life's Journey (a grief counselor, a mentor, a business coach, even a really solid math teacher all serve similar roles).

Meditation can be what the Monk who can lower their heart rate and respiration significantly does, sure, and it is also the busy parent who takes the first sip of each cup of coffee mindfully. When we use Mindfulness Meditations, we're actively engaging in bringing our attention to one single thing, without judgement on *how* we are doing it, or even *how* the activity ranks on past similar experiences, etc. It is taking that sip of coffee and noticing the movement of the muscle in our lips and mouth and hand on the mug and the temperature and texture of the cup and the texture in the mouth and the bitter (or sweetened) flavor and the way our mouth works to bring it down our digestive tract, feeling the temperature as it travels that path, the sensation of awakeness that one may feel as a result. Or Mindfulness can be taken onboard as a reflection after an unexpected thing has happened, such as stubbing one's toe, sharply inhaling and, prior to shouting a string of expletives. The more often we engage in this practice, the more likely we are to find the generally illusive ability to SLOW DOWN in a fast-paced world and make a choice instead of falling into a knee-jerk reaction. I happened to hear Dan Harris on NPR yesterday when returning from picking up my curbside veggies, so I'm going to share that link here. He does a lot with Mindfulness and has a very "approachable" approach, which a lot of people feel is a good place to start. https://www.npr.org/sections/health-shots/2020/05/19/858551813/anxious-meditation-can-help-you-relax-into-the-uncertainty-of-the-pandemic

When it comes to the Relaxation Response, try this as a simple place to start (and I'll pick back up with more on these topics next time), Inhale for Four Counts, Hold it for Two Counts, Exhale for Eight Counts. Do this Three Times in a Row. This is an adaptation of a skill I've taught for over a decade with a twist taught to me by Kate Sullivan, Hypnobirth Instructor and Doula. The extended exhale is a way of activating our Relaxation Response and putting us into a space of stress-reduction -- aka The Sigh of Relief (longer exhale).

These are just two areas of Mindset we can activate to make better choices, start creating better feeling thoughts and change how we approach our lives, not just for birthing, for any period of adjustment or transition. Next piece, we'll look at another aspect of how you can use Mindset for your Journey!

*Validation for those who had scary, sad, negative or painful births, your experience is absolutely valid. There is a lot around a birth experience that has already happened. If there was an unexpected outcome, for instance, that's going to color your experience. For one of my dear friends, just not being able to get into the tub was a hard thing to accept after that had been the plan. For my bereavement doula clients, obviously, there is a bittersweet when recollecting even the most "beautiful" of births and welcomings before saying farewell to their new little love. So, for those who gave birth and experienced pain, your experience is your experience and that is valid for you. I have seen, mostly in my first year or so as a doula, before I became a birth educator and included more training for my clients in my packages, folks who were scared in labor and they experience every contraction as pain, even suffering when they did not have adequate knowledge, or support for their birth wishes from their provider or partner, or (big one here given how common this is), when there was a past history of personal trauma or sexualized violence. In fact, many of my clients hire me because their first birth did not go as well as they'd hoped, though, thankfully, as the word of how doulas are an evidence-based method of having more a more satisfying birth experience and so on, many doulas are seeing both a general increase in interest an increase in first time birthing parents too. And, it is also worth noting that sometimes, baby's position or the position one is laboring in increases discomfort significantly. There is a lot to this all. It's also true that a good doula and solid prenatal birth education, especially when it is rich in Mindset Skills, can provide a great deal of relief and powerful reframing for powerful sensations. So, if you've had a baby already and it was painful or difficult and you're ready to do it again, but maybe differently this time, seek out some support in healing that past birth experience and preparing differently for this one.