In this in-depth discussion, we talk with Dr. Claudia Piccioni about the “uncomfortable” feelings associated with perinatal bereavement. These “uncomfortable” feelings include all those experiences and emotions that, following a perinatal loss, emerge with particular intensity in interpersonal interactions and can place a heavy strain on people’s relationships.
Since we’re talking about discomfort in relationships, let’s try—as we read this article—to find a comfortable position as much as possible: let’s pay attention to how we’re sitting, to the lighting in the room, to what might help us feel at ease, and, if we need it, to some form of comfort.
Perinatal grief can bring with it emotions and feelings that are difficult to understand—first and foremost for those experiencing them. Sometimes these experiences challenge the image we have of ourselves and the way we’re used to seeing ourselves. For example, we may consider ourselves generally not very envious people, only to discover that, after the loss, envy surfaces with unexpected intensity and leaves us feeling disoriented.
Furthermore, in cases of perinatal bereavement, there is still far too often a lack of adequate recognition from others: few words, few rituals, and little social space to express grief. This lack of recognition can make it harder to understand and validate what we are going through and can exacerbate certain difficulties in relationships, including those related to envy, shame, and guilt.
Envy, shame, and guilt are “uncomfortable” in part because they can be intense, take up a lot of space in our emotional experience, and affect our relationships. We find it hard to talk about them and may fear not being understood or, worse, being judged.
Consider, for example, how easily guilt can become intertwined with shame: “Since I made a mistake, then I’m a bad person.” Sharing thoughts like these with others can be very difficult.
We will discuss these emotions separately, even though we know that in our emotional experience the boundaries are not so clear-cut: emotions, feelings, thoughts, and relationships are constantly intertwined.
Envy
Anyone who has lost a child may suddenly find themselves immersed in a world that seems full of children, pregnancies, and families.
Envy toward those who have healthy children or toward families perceived as “intact” is a very common experience in perinatal bereavement, but it can be accompanied by great distress because it is easily interpreted as something “bad”—something we shouldn’t feel.
In fact, in this context, envy can be understood as a response to the pain of loss. It does not necessarily mean feeling hostility toward the other person: often, what hurts is seeing in others something we deeply desired and have lost.
“Why them and not me?” is a question that can arise spontaneously. It speaks to a sense of injustice, to the sense of loss, and to the void left by that loss.
Envy, in this context, refers primarily to desire and loss, not to a moral failing.
Shame
While guilt tends to focus on what we have done or think we have done, shame more directly involves the image we have of ourselves: “I am wrong,” “I wasn’t able to,” “I am not worthy because I didn’t carry the pregnancy to term.”
That is why it can be particularly painful and paralyzing.
Pride can be considered, in some respects, an emotion that is the opposite of shame. If we are people who are accustomed to placing great value on meeting expectations—whether our own or those of others—or if we grew up paying close attention to “what people will say,” it can be particularly difficult to face experiences in which we feel exposed, vulnerable, or inadequate.
While pride can bolster our sense of effectiveness and self-worth, shame can directly undermine our self-image, shattering and wounding it.
In perinatal grief, shame can affect various aspects of the experience.
The body. You may feel as though you have failed—as if your body has betrayed you, your partner, or your child.
Social visibility. Perinatal loss can be subtle and often goes unrecognized: “To others, I’m not a parent.” This can fuel the feeling that one does not fully have the right to grieve.
Social Silence. When the people around us downplay or fail to acknowledge what has happened, it can reinforce the idea that our grief is excessive or disproportionate—and that, therefore, it is something to hide or be ashamed of.
Shame can lead to isolation, to a desire to disappear or to hide from the gaze of others. And isolation, in turn, can amplify that shame and pain.
Guilt
Guilt relates more directly to what we think we have done, failed to do, or could have done differently.
We hear this very often from parents after a loss:
“I should have realized it sooner.”
“Did I do something wrong during my pregnancy?”
“I didn’t do enough.”
“I wasn’t able to.”
“I was thinking about something negative, and it happened.”
Guilt can be the mind’s attempt to regain a sense of control in the face of an event over which we had very little or no control at all. Even when we know rationally that what happened was beyond our control, the need to find an explanation can turn into self-blame.
We can then keep going over the details of what happened, searching for a “I could have done things differently,” as if there were some alternative version of the story in which the child’s death could have been prevented.
There is also another possible purpose to this search: if I can find a cause, perhaps I can prevent it from happening again. Guilt can thus become an attempt to protect ourselves from uncertainty and fear, even if the price we pay is great suffering.
When it persists, guilt can gradually become part of the image we have of ourselves, to the point where it almost defines us.
Perinatal grief can take various forms. Among these, we can identify at least three.
Survivor’s Guilt: “I suffered less than my son,” “I outlived my son,” “I’ve now spent more days without her than I did with her.”
Guilt over the separation: “I abandoned my son.” Or, when you slowly start to feel better again: “I’m forgetting him,” “If I don’t think about him all the time, I’m not a good mother.”
Overwhelming guilt: “I am responsible for my son’s death.”
It can be important to work through feelings of guilt, especially when they become like a garment that’s too tight and from which it seems impossible to break free. Guilt can, in fact, fuel rumination and contribute to prolonged suffering.
“Gentle” Ways to Deal with Uncomfortable Feelings
We can’t choose not to feel what we feel. In fact, the more we try to suppress or push away an emotion, the more it continues to take up space inside us.
However, we can gradually learn to relate differently to what we feel.
Remember that we are not the emotions and feelings we experience. Emotions, feelings, and their expressions are responses to what happens inside and outside of us. They can be very intense, but they are also experiences that change and evolve over time.
Learn to recognize and name what we feel, while trying not to judge it. We can try telling ourselves, “I’m feeling envy,” without immediately adding, “I shouldn’t feel this way” or “I’m a horrible person.” Changing the way we view an emotion can also change our relationship with it.
Separate responsibility from control. Just because something happened doesn’t mean it was within our control or, more importantly, that we could have prevented it.
Give the child and the bond space to grow. Writing, creating a small ritual, saying the child’s name whenever we wish, or finding other personal ways to remember him or her can help us acknowledge the relationship and our role as parents.
Don’t rush the process. The pressure to “get better quickly” can increase feelings of inadequacy and lead to isolation—precisely when we need time, a listening ear, and closeness the most.
Don’t stay alone; seek out safe spaces where you can share. We can talk to someone who is able to listen without judging, choose friends and loved ones with whom we feel we can share what we’re going through, reach out to self-help groups dedicated to perinatal bereavement—where these feelings are understood and accepted—and seek, when we feel the need, professional psychological support for perinatal bereavement.
In thanking Dr. Claudia Piccioni, I’d like to conclude by noting that part of the grieving process involves getting to know ourselves anew—even through emotions and feelings we never imagined we’d experience. Uncomfortable feelings are part of this journey: as I always say, they are one of the “thousand forms that nostalgia takes for those who left us too soon.”
