CONFERENCE PAPERS 2007

Find Below:
1 Story giving birth to Hope (Peter Maher)
2. Pregnancy Proneness: The Hidden Agenda (Anne Neville)
3 Interview with Theresa Burke in Hobart (with Penny Edman)

1. Story giving birth to Hope
Learning method and spirituality of Rachel’s Vineyard Ministry
Peter Maher, Bth, M Ed (Adult), Sydney priest

When I was first introduced to the Rachel’s Vineyard Retreat, I went along with the experience which I trusted because of my friend, Julie Kelly. I was intrigued by the enthusiasm and clarity of the healing Julie described. During those early retreats I was struck by the transformative power of storytelling in the retreat process. I remember quite clearly participants recalling on the Saturday of the Retreat the horror of the abortion event, what led to the abortion, and its effects with predictable expressions of hopelessness; pain; low self esteem and inability to find healing, forgiveness and love. With almost equal predictability, these factors in the stories were transformed in just a few short hours into stories that held out a hope for change, recognition of the reality of what had happened and a chance for healing from the debilitating grief and loss that had been a constant part of their lives. I became interested in what brought about that change. The storytelling process is one that has the power to help retreat participants see the story again from a new perspective; recognise who is suffering and in need of healing and rewrite the story in a way that is more truthful. They now hear themselves describing the event and its effects with greater compassion for themselves and others.

Many events occur in our lives that disorient us. It might be falling in love or a car accident, Taking an overseas holiday or loosing a loved one – these events can have a transforming effect in our lives or leave us overwhelmed and unable to function - at least temporarily. In transformative learning these events are referred to as the disorienting dilemma. ( See: Mezirow, J. (1991). Transformative Dimensions of Adult Learning. San Francisco, CA: Jossey-Bass) The disorienting dilemma can be used to help someone grow or it can be a missed opportunity for growth. For many participants on Rachel’s Vineyard retreats they have found the abortion experience to be the latter. Those working in this ministry are privileged to facilitate processes that can turn that around and allow the disorienting dilemma to become a moment of growth.

Rachel’s Vineyard Retreats can be viewed through models of learning healing through mutual nurturing. This learning takes place through rituals such as living scriptures, prayers and/or the Sacraments and storytelling. These practices address healing from pain and grief in a gradual and gentle way. It is based on a carefully managed expression of pain and grief.

Rachel’s Vineyard Retreat draws on a number of educational methods. I will look at two - autobiographical learning and emancipatory learning. These two operate in a similar terrain but from different perspectives. Autobiographical learning is based on the principle that a person’s story can be a research tool. By using various methods to tell my story, I can reascribe meaning to my story and so I can learn new ways of understanding my story. For learners to change their meaning structures - that is, beliefs, attitudes, and emotional reactions - they must engage in critical reflection on their experiences, which in turn leads to a transformation of perspective. Emancipatory learning is based on the practice of naming and renaming my reality so that I can get beyond the oppression of being overwhelmed and paralysed. It is about seeing what confronts me in ways that invite action. “In this process of naming and renaming, the learners come to know their world not in terms of givens to be uncritically accepted, but in terms of problems to be addressed. As the learners think, so they must act”. (Newman, Michael, p 232, Maeler’s Regard,1999, Stewart Victor Publishing)

Both these models of learning engage the learner in questioning their own story and their position in the world. Learners are invited to create new ways of seeing their reality. Emancipatory learning uses practices to engage the learner in devising action that frees the person for a better life. Autobiographical learning is a process of remembering; focusing; locating in context; asking what I learned; how I learned and why I learned by telling my story. Emancipatory learning is interrogating the story, naming and renaming the experience to gain freedom from constraints; to become conscientised to my reality and to be challenged to act in ways that liberate. Emancipatory education uses symbol such as drawing; story and pictures to unpack what is trapped in present practice. It invites us to action for freedom. It is a political process in the sense that it challenges us to action and to new ways of responding to our reality.

Rachel’s Vineyard Retreats use these educational theories in many ways. Storytelling, letter writing, poetry and music are autobiographical learning techniques, while role play, ritual, anger letters and meditation are emancipatory learning techniques. The storytelling can enable people to own their reality; ask questions about the experience and interpret or reinterpret it. For example, writing anger letters enables us to articulate anger or realise the power of anger in a relationship or the need for forgiveness in the grieving process. These reascribe meaning to the story or caste the story in a new light or help us to see ourselves in a larger context and thus we see ourselves with greater clarity. It is with this new clarity about reality that I am empowered to act in new ways that respect those affected by inaction which includes myself and those around me.

Role play around the stories along with appropriate debriefing interrogate the story so to speak. It is as if the learner is asking the story questions about the accuracy of the initial interpretations. Ritual engages the learner in seeing themselves in new ways in relationship to Jesus, God and others, including the baby. Meditation uses the imagination to add a new dimension to the story. Rituals and reflection questions using the process of imagining being in the story allows people to see themselves in new ways and reinterpret the meaning of their story or find the place where they are stuck in their lives. These practices tend to push the person to action not only because it seems to provide a better outcome but because these practices also open up suggestions about how to act as they tend to engage the imagination in seeing themselves differently; seeing the context differently and increasing options for action. While true emancipatory learning always comes from a partnership between learner and teacher; there should be no mistake it is the teacher or facilitator who offers a directive process for the learner to understand and engage in transformative action. Thus teachers or facilitators of life learning in an emancipatory model are not unattached. In this form of education they take sides. Paulo Freire, the father of popular education, as it is called, noted that to remain neutral is to side with the oppressor. Rachel ministry is unapologetic about siding with the victim – that is the one who is hurt. In the story of those suffering post abortion pain there are various hurt people. One is the baby and so the baby is honoured and remembered. The other is the woman or man whose pain and grief is honoured in order to bring reality to their struggle, siblings, other family members, health workers and friends.

There are a number of cautionary points that are usually made by theorists when using these forms of adult education. These include:
• Need for confidentiality
• Informed consent – learners have a right to know what will happen to their story and how it will be used
• Respect for the person
• Appropriate support for the process
• Clear instructions on process and what will follow
• Careful opening and closure to avoid leaving people exposed
• Good debrief practices
• Offering appropriate and professional follow up
• Making clear the purpose for telling the story in the group (so it is not perceived as voyeurism)
• Be clear about boundaries – what part of their story is to be told
• Insisting on a climate of honesty
• Gradual development in a respectful process
• Respect for individuals’ comfortable levels of self disclosure
• Facilitator is part of the process. We are all teachers and learners. Self disclosure by facilitator is helpful when appropriate
• Maintaining a culture of a freedom to disclose while insisting on maintaining the communal agreement of the purpose of the process
• Clarity about how to deal with conflict if it arises – what is acceptable and how to curtail unacceptable levels of conflict in the group
• Inviting feedback and evaluation of the process from the learners – to assist learners to note what has happened and facilitators to develop good practice
• There needs to be adequate planning to avoid any noticeable lack in professionalism that can lead to lack of confidence in the group. This is particularly important when working with vulnerable people or people making themselves vulnerable in the group

Ministers in this ministry may find this theoretical background useful in planning retreats and making decisions on retreats when circumstances require adjustments.

However it is not only good educational and psychological theory that contributes to the success of the transformation of lives through Rachel ministries. The retreat is based on a firm spiritual practice that is well expressed in the following quote from Sr. Joan Chittister. She reminds us that it is the supportive community that is essential to healing. Both methods of adult education discussed above also support this point. She recalls attempted methods of healing that have negative and positive results.

Chittister says:
“Strangers came together in weekly workshops to reveal to one another their most secret fantasies, their most shameful actions. They shouted one another down, gave way to inner angers a lifetime in coming, “let it all hang out.” Satisfying the emotional demands of the moment, the gurus of the movement told us, is the measure of our humanity. It did not work.

Too often, people withdrew from the encounters more hurt, more rejected, more emotionally confused than ever. Now they knew intimacy but not love. Worse, now they were left with old wounds newly opened and not a clue about what to do with them in the future.

They had expressed their emotions but they had not struggled with them. They had revealed their hurts but they had not worked through them. They had exposed their agonies but had not put them down. They had lost control of themselves and gained nothing to put in its place. Feelings oozed out of people like oil, over everyone and everything they touched, but the pain remained and the soul stayed dry. There was clearly something missing. The expression of feelings was simply not enough to dispel the suffering.” Joan D. Chittister (2003), Scarred by Struggle, Transformed by Hope, Wm. B. Eerdmans Publishing Company, p 34.

Chittister then invites us to consider the spirituality that accompanies good healing practices. She reminds us of the spirituality of detachment in our Christian tradition and the place it plays in identifying the truth of who we are, the reality we inhabit and the hope born of finding ways to stay with our humanity in simplicity. Detachment, she says, is honouring the void within by practices that allow us to be with ourselves as we are. Examples of such practices in Rachel ministries are the meditations in the living scriptures, a quiet time to walk and digest realities, the anger letters, having the doll baby overnight and sitting with the letters to the babies. Chittister notes that these kinds of practices done in a supportive community enable the struggle to be safely undertaken in the divine presence. And that this kind of struggle is where hope is born.

Again I quote Chittister:
“Over centuries, detachment lost its spiritual glow. Distorted by the excesses of extreme asceticism but at the same time, paradoxically, always regarded in its classical sense not as a way to deny the world but as the spiritual key to living in it more freely, detachment became the counterfeit coin of the happy life. It dampened feelings rather than sharpened them, its critics said — and not without reason. Jansenism, with its emphasis on ascetic discipline, became popular among French Catholics in the eighteenth century. In the name of holiness, it suppressed emotions rather than listened to them. It rendered the world dour and living an act of denial. In doing so it destroyed what is needed most in a time of struggle: the will to live because the world is bountiful. Detachment based on negation rather than an awareness of endless abundance is not a solution. At its healthiest, the human spirit is irrepressible and the human heart seeks hope, not desolation, however disguised dearth may be in the trappings of holiness.

But the truth remains: Nothing lasts. No single thing can consume our entire life’s meaning. No single thing can give us total satisfaction. Nothing is worth everything: neither past, nor present nor future. It isn’t true that the loss of any single thing will destroy us. Everything in life has some value and life is full of valuable things, things worth living for, things worth doing, things worth loving again. It is only a matter of being detached enough from one thing to be open to everything else.

The essence of life is not to find the one thing that satisfies us but to realize that nothing can ever completely satisfy us. And that’s all right.” Joan D. Chittister (2003), Scarred by Struggle, Transformed by Hope p 36-37

There is a deep spirituality of detachment and truth telling in the processes of Rachel ministries that leads to transformation and hope when done in a supportive community.

I heard Richard Rohr speak in Sydney last year on the topic of gospel spirituality. I believe his key point can help us to name another dimension to the spirituality of transformative learning in Rachel ministries. He noted that we often live with a dualistic mind that wants to insist that “I am not like you” – I don’t do bad things like you do; I don’t smoke, drink or get fat like you do; I don’t waste my life and I would certainly not have a an abortion! This, he claims, is the destructive mind. Gospel spirituality emphasises that in fact “I am just like you”. We are reminded that we are vulnerable, hurt or in pain; we have all made mistakes and are all equally in need of God’s love and self forgiveness to find happiness and wholeness.
The dualistic mind leaves us scapegoating someone else as the problem and identifying the issue as always somewhere else – we never really are quite able to help. But the loving mind that is in touch with the reality of all things sees it another way. Not only can we be forgiving of ourselves and others but with the “I am just like you” spirituality, the forgiveness of all is intimately tied to self forgiveness. One comes in alliance with the other. The dualistic mind leaves us both unhealed. This can be seen in the so called “war of terror” – while we scapegoat Muslims, Iraqis, jihardists, etc. - we can never address the real problems that cause unrest, poverty and exclusion in the world. These produce fear and violence born of false dichotomies; ethnic stereotyping, frustration and powerlessness.

People who can’t live the new life of forgiveness are thus left to live their old life over and over again. The dualistic mind imputes guilt, apportions blame, needs to find the one responsible, exacts retribution and scapegoats the other.

Jesus brought to religion the non-dualistic mind claiming God’s love falls on the good and bad alike. Forgiveness is possible in every situation because God is deeply at the heart of everything and everyone. Often those suffering post abortion trauma exhibit this lack of self-esteem and the inability to understand why they are caught in a whirlwind of presenting symptoms of abuse and addictions that reoccur as if on a merry-go-round at a fair ground run by some crazed torturer who will not stop the machine. This cycle of self abuse can only be stopped by the non-dualistic mind that knows God’s presence in everything including the abortion experience and its aftermath. Then self love is possible again.

The transformative learning method of the weekend is designed to identify the common ground of the human suffering; to recognise that the love of God is aching to enter every heart and that this love is not a result of being good. Through its practices Rachel ministries engages the non-dualistic mind through metaphor, music, poetry and prayer and sharing of story in a way that leaves room for reinterpretation. Various storytelling methods are very valuable tools for doing this. These processes enable the storyteller to find a new language for herself or himself. At best they flow from the process – we often say even when things seem to struggle on a retreat – let’s trust the process. The art of the facilitator is to enable the retreatants to find another voice inside themselves that they didn’t know was there. The authentic self - the voice they can trust. They have had a lifetime of voices they can’t trust – the new inner voice which emerges from interrogating the story is actually their voice – the one they didn’t know they had. It’s the one that invites them to know – often for the first time – that “I am just like you” all round the room. I am not less than anyone else and I deserve love and healing like everyone else. The non-dualistic mind is engaged in rewriting the story as a person who is also a victim and who has a right to survive. We are saying: “I have come that you may have life and have it to the full” acting in the person of Christ. We are saying to them - You are not alone; your story is one among many; don’t stay trapped in a downward spiral of self violence because there is hope – look we are all still here after all that pain. The new story they are writing for themselves is one where they can incorporate the whole self; where God and goodness reside precisely with the struggle and confusion.

This gospel spirituality combined with a spirituality of detachment is the context for the transformative learning practices of Rachel ministries. I have only touched on a couple of ideas in this talk to try and show that Rachel ministries, and especially the healing retreat, have firm foundations in good transformative learning practices. They are successful when they are practiced and celebrated in a supportive community with sound spirituality.

Let’s continue with confidence.

(Anyone is free to use this paper, or any part of it, free of charge with the following note: Paper given at Rachel's Vineyard Retreat Conference, Sydney (2007). Used with Permission, Rachel's Vineyard Retreat Ministries, Australia.

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2. Pregnancy Proneness: The Hidden Agenda
Anne Neville
R.N., R.M., Dip. Past. Psych., Dip. Marriage & Family Therapy, Dip. Interpersonal Relationship Therapy,
Accredited Counsellor National Association of Loss & Grief, Clinincal Member ca.p.a.v (PACFA approved)
Director of Counselling, Open Doors Counselling & Educational Services, Ringwood, Victoria.

*All names used in case material are fictitious to maintain client confidentiality.

This paper looks at the deeper underlying issues that may contribute to an unplanned pregnancy. Our findings are based on a number of studies and research articles as well from a vast amount of anecdotal evidence from our clinical work.

Time and again women present for a pregnancy test when clearly it has not been their intention to become pregnant. Obviously, a number of women come because of failed contraception but others seem to be clearly governed by other forces. Even those for whom contraception has failed may be influenced towards an unplanned pregnancy by secondary issues. This is particularly so for those women who have a number of pregnancy “scares”.

Germaine Greer, in her new book “The Whole Woman” asks:
“If we accept every instance of abortion as the outcome of unwanted and easily avoided pregnancy, we have to ask ourselves how is it that women are still exposing themselves to this risk.”

This is the woman who is well known for her passionate stance on female equality and autonomy bewildered at the seeming lack of progress in the area of sexuality and reproduction. She seems to be aware to some degree that there may be greater forces involved.

We refer to this phenomenon as Pregnancy Proneness i.e. a predisposition to a pregnancy that is neither consciously desired nor planned for. Just as it seems that some people are more prone to accidents so it would seem that certain individuals are more likely to find themselves faced with a pregnancy scare or the decision whether to continue a pregnancy or not.


Psychological Predispositions to an Unplanned Pregnancy

One would expect that sex education and training in the use of contraception would be the logical solution to the problem of unwanted pregnancies. However, the widespread application of these ideas has in no way eliminated the problem.

One only has to consider the current abortion figures to see that women are still becoming pregnant despite the provision of preventative education and the availability of many different forms of contraception. Its very failure shows that we are not dealing with the mere mechanics of anatomy and physiology but with a more complex situation. Many women, not just adolescents, continue to be unaware of how their bodies work, fail to understand fertility cycles and are often unclear about which specific sexual activity can result in a pregnancy.

Whilst there has been a dramatic decline in the birth rate and especially that of babies born to teenage mothers this figure in no way represents the true number of unplanned pregnancies in Australia - it doesn’t take into account the number of terminations performed. According to the figures from the South Australian Abortion Reporting Committee for 2005, the abortion rate for women aged between 15 and 44 years of age was 15.3% - a slight decrease from the previous year’s figures. The teen abortion rate has shown the biggest fall from 21.1 to 17.7 per 1000 women. The 20 and 24 years age group continued to have the highest abortion rate followed by the 25 – 29 years age group whose rate now exceeds that for the teen group.

These figures obviously do not take into account the use of emergency contraception that is now freely available to women through pharmacies throughout Australia.

Also from the 2005 South Australian figures, the proportion of women having repeat terminations of a pregnancy stands at 38.8%. Almost half of those in the age groups 25–29 years and over have had previous terminations. Of those aged 20-24 years, 36.3% had had a previous termination. Figures from the Government of South Australia’s “Pregnancy Outcome” Report suggest that 29% of women would have an abortion in their lifetime if they experienced the abortion rate of the different age groups for 2005.

It is interesting to note that a single experience of “unprotected” intercourse (where no contraceptive measures are used) carries a 4% chance of conception taking place (Abernethy, 1980). However, unprotected intercourse over a twelve month period at an average frequency has been shown to carry an 80% risk of pregnancy (Abernethy, 1980).

Whilst some might say that to continue having unprotected sex is madness at its best, it would seem that the human drive to reproduce is incredibly strong even in the face of consciously considered obstacles. We would have to wonder at the influence of natural biological and psychological forces to reproduce that possibly conflict with the current trend to delay childbearing.

Women contacting us are usually in a state of crisis. The immediate problem (a pregnancy) may seem to be the only problem particularly to the adolescent - with little awareness of the deeper issues, which may actually underlie the pregnancy. It is these deeper problems that pre-dispose a woman or couple to an unplanned pregnancy - hence the term “pregnancy proneness”.

It’s been found that some women seem to have a tendency to conceive more frequently than others and in situations where they believe it is not their conscious intention to have a child. The teenager usually does not deliberately decide to become pregnant, although there are some instances when this is so.

Beverley Raphael in (1972) described a range of underlying issues leading to the conception of a child at a time that seems inappropriate to the mother. These include - depression, replacing a loss, deprivation and hostility in childhood, uncertain femininity, and self-punishment.

At Open Doors we often see evidence of these factors in the life stories of women who seek a pregnancy test and counselling.

Firstly, we will start by considering:
Previous Loss and Depression.

A number of studies have reviewed possible factors leading to problem or unwanted pregnancies. These showed, in approximately two thirds of the women studied, a history of loss in the previous six months prior to the problem conception. In 50% of these women, the loss had actually occurred in the previous three months (Greenberg, Loesch and Lakin cited in Raphael, 1972).

A recent loss is a very common feature in the history of clients at Open Doors - especially those who have had an abortion or a miscarriage. Many suffer from reactive depression related to their pregnancy loss and become “stuck” in the depressive phase of their grief work.

Significant losses include:

• A death
• The separation/divorce – relating to parents or self.
• A relationship break up
• An abortion
• A miscarriage
• The last child going to school
• A decision not to have any more children
• Children leaving home
• Moving house
• Change of roles
• Menopause

These changes and losses can result in a degree of depression and, consequently, lead to a state of vulnerability. It is this vulnerability and its accompanying needs that may lead a girl or woman into behavior that seeks to compensate for an emotional loss. I’m referring to the drive towards physical and sexual contact to fill the psychological void and the often accompanying lack of contraceptive vigilance. Grieving people will speak of a “hole” or an “emptiness” which, somehow, needs filling.

Many women who find themselves pregnant unexpectedly present with some degree of depression and, when drawn out about their situation, speak about losses that continue to have an influence. This can best be described as a “masked grief” (Lamb, 1988) that is a form of complicated mourning. For final resolution it is necessary for the particular loss to be dealt with.

Adolescents are particularly vulnerable because of their immature cognitive and emotional development. Family breakdown through divorce and separation of parents is one area of loss experienced by a growing number of adolescents. They seek to replace lost parent/child relationships through sexual activity in a futile search for parental intimacy and affection. They become vulnerable not only to an unplanned pregnancy but also to long-term emotional difficulties. Their contraceptive awareness is often compromised.

The misguided impression that “it couldn’t happen to me” often over-rides prudence and is frequently a feature of adolescent thinking. Often there is little or no thought of the possibility of a pregnancy. The psychological drive to fill the emotional gap often channels the need for intimacy into a sexual relationship.

Behavior is governed by emotional pain and unmet needs and so the cycle can become repetitive.

“Melanie”, 16, lost her maternal grandmother after a long illness just 4 months prior to her first contact with Open Doors. Whilst she came for a pregnancy test, she spent a lot of her time with the counsellor focusing on her close relationship with her grandmother and what the impact of her death entailed for her. The opportunity to deal with her grief had been severely restricted as Melanie’s parents’ marriage was floundering and she felt she could not add to their problems by saying that she wasn’t coping. In an attempt to deal with her pain Melanie sought comfort in alcohol and a physical relationship which she later recognized as further compounding her difficulties. Fortunately, Melanie’s test was negative.

The second factor to consider is:
Replacing a Loss.

A significant factor involved in the grief response is the impact of parental separation and divorce. Reports from a British study (Kiernan and Hobcraft, 1997 cited in Family Planning Perspectives, Vol. 29. No.5) noted that “individuals who experienced parental divorce during childhood were younger than average when they began having sex, entered their first marriage or cohabiting relationship and had their first child” (p.242) Women from disrupted families were almost 50% more likely to have entered a co-habiting relationship before the age of 20 and were twice as likely to have become teenage mothers.

In cases when there have been a considerable number of losses experienced we have seen disappointment expressed by teenagers when the pregnancy test was negative. A number of young clients have acknowledged their disappointment and their longing for a baby - as “someone to love and someone to love me”.

For “Elise” the disappointment that she was not pregnant was quite apparent. After experiencing difficulties at home she existed by living in numerous squats and on the streets. Life, in her opinion, was meaningless and a baby represented a chance - a source of motivation to get her life in order. It seemed she was unable to do that just for herself but a baby would somehow fill the emptiness and offer her something in return.

For some girls becoming a mother actually provides them with the motivation necessary to get their lives on track. They discover and develop a potential they didn’t know existed. Their lives, goals and relationships are re-evaluated and they can actually bloom.

Although there is a great lack of research into the unconscious motivation or desire to replace a lost pregnancy with a subsequent one, case studies show that for some this occurs. Frequently it is found at Open Doors, that the date some women come for post-abortion counselling coincides with the anniversary dates of their abortions or the expected due date of the aborted child. Very often the pain of the loss is buried for a time until there is a significant trigger to re-activate it. Many do not actually connect the emotional response with the abortion until it is explored or pointed out.
Our case studies show that for some women there is a tendency to find themselves pregnant again quite soon after a pregnancy loss - whether it be a spontaneous miscarriage or an abortion. This is an attempt to replace the baby that has been lost. In the U.S. a review of literature noted that “a miscarriage might delay a birth by as little as 3 – 4 months” (Hoffman, 1998, pp. 239). Many find themselves pregnant again within 3 - 6 months.

After a recent termination “Tracy” returned to Open Doors for a further pregnancy test. She was very clear that if her test were positive this time she would be continuing the pregnancy.

Tracy had believed her family to be complete when she found herself pregnant again at 36. Her 3 children were all at school, she was back in the workforce and she and her husband were at last experiencing an improvement in their finances. The decision to terminate the pregnancy was made fairly quickly.

Afterwards she found herself grieving - something she did not expect to do. She realized that the decision to abort the previous pregnancy had not been the right decision for her. In talking with her counsellor she became aware of her desire and attempts to wind back the clock and replace the baby she had lost. Indeed she realized that she had taken active steps in a misguided attempt to do this by “forgetting” to take the Pill.

For some their post abortion grief produces what could be described as quite bizarre features.

One young client “Sharna” was convinced her baby was waiting “just here” (indicating to the right at head height) for her to conceive again so that “she” (the baby) could return. She said she could “hear” her baby talking to her telling her that she wished to return. Sharna wanted to pinpoint ovulation to make sure that her baby had a chance to return in a subsequent pregnancy. Sharna’s grief had taken on a delusional aspect. She was in need of a great deal of help to face her loss and grieve. Unfortunately she did not continue with us so we don’t know the outcome for her.

Some women will systematically engage in sexual activity very consciously in order to become pregnant. Some will even trap their partners with assurances that they are on the pill. The drive to replace the lost child can be incredibly strong. Sometimes we hear it said that women just have babies to rort the system and secure benefits. However, to hold to that opinion would be somewhat shortsighted in light of the issues we find common in the histories of many women.

It is also a notable occurrence that women seek a pregnancy test around the anniversary date of the loss of their child or around what would have been the expected date of birth of that child. These are times of greater vulnerability and emotional flooding. So often there may only be an awareness of an increased restlessness and heightened sadness without the emotional response being connected directly to the loss.

For others there will be a very definite “trigger” that will cause their grief to surface.

A caller on our grief line sobbed as she spoke of the intensity of her loss for a baby she had aborted at the age of 18. The news of her daughter’s first pregnancy had led to the upsurgence of her own grief, which had never been expressed. “Helen” spoke of her persistent battle with depression, which intensified at certain times of the year. After identifying that these times coincided with the termination and when the baby would have been delivered “Helen” acknowledged a great feeling of relief - these events now made sense.

The third area for consideration is:
Deprivation and Hostility in Family Background.

Girls and women who experience unwanted pregnancies frequently show certain consistent patterns of particular family interactions.

Some of these features include: -
• A hostile or distant relationship between parents. This can produce an insecurity and influence the degree of autonomy the girl will be able to exercise.
• A poor relationship with both parents – allegiances may shift because of a conflict in loyalties, undermining her self-esteem.
• A contemptuous relationship with the mother - particularly where there has been abuse by an overbearing and dominant father. The lack of a firm role model may influence decision-making and may affect how the girl may relate to men.
• Male-pleasing behavior in the mother. The unequal relationship may cause girls/women to adopt a submissive role with males and devalue relationships with other females.
• An unsatisfactory or distant relationship with the father. This may lead to inappropriate relationships wherein she attempts to make up for a deficit in the father/ daughter relationship.
(Studies quoted in Abernethy, 1980)
Again, many of these factors are evident in lives of our clients. They are disadvantaged and, therefore, vulnerable and may find it difficult to control sexual activity to prevent a pregnancy from occurring. Loneliness, boredom and the lack of sense of direction in life are common features of the disadvantaged teenager (Condon, 1994). A pregnancy can represent both an opportunity to escape from a dysfunctional family and also a dreamed of “new start” - often bordering on a fantasy.

Even when contraception is being used teenage girls report the tendency to become “clumsy” about its use (Fahy, cited in Twist, 1994). Motivation to ensure against a pregnancy is often influenced by the perceived lack of alternatives available to girls from impoverished backgrounds. Sexual activity is symbolic of the deeper needs and a resultant pregnancy may be an attempt to fill the need of the girl for love i.e. someone to love her who won’t hurt her. Having a child may psychologically provide the young mother with an opportunity to attend to her own emotional growth process. As she projects her love out to her child she is then able to receive the reciprocal loving from the child.


“Julie”, 14, certainly came from a background where most of the above criteria was evident. Her parents had divorced several months ago after many years in a relationship where there had been regular and extensive physical and emotional abuse. Her mother had since been involved in numerous unsatisfactory relationships with equally dominant and aggressive men.

Julie was critical of her mother’s behaviour and felt she didn’t care about her - she said her mother was too busy “ doing her own thing”. Her father she rarely saw despite her repeated attempts to contact him. She was basically left to her own devices.

She engaged in sexual activity seeking closeness, a scenario she saw modeled by her mother who was possibly seeking to meet her own needs this way. There was little or no thought of using contraception. Because of her age and the stresses she was trying to cope with Julie operated with a great deal of “magical” thinking, denial and a restricted ability to consider the consequences of her actions.

This response is by no means confined just to the adolescent.


The fourth factor is:
Uncertain Femininity.

For some a pregnancy, although untimely, actually confirms the feminine role - that is the ability to conceive and have a child. The need to prove this comes through with varying degrees of awareness in many of our clients.

Our client “Helen” referred to previously expressed something of this when she spoke of her pregnancy as a teenager. She said that she had always wanted a large family but had a doubt about her capacity to have children because of late development and gynaecological problems.

Confirmation of her pregnancy was in one sense a great relief for her but, on the other hand, she was then faced with the agonizing decision of whether to continue the pregnancy or not. Believing she had no other option she chose to terminate. Until the actual birth of her first child she battled with the fear that the child she had aborted would be her only chance at motherhood.

Hostility in parental relationships coupled with an inequality in that relationship may affect how the young girl sees her own gender role. She may doubt her ability to maintain her sense of self in ways other than through acquiescence in a sexual relationship.

The National Survey of Family Growth in the United States in 1995 examined the actual degree of control that young women exert over first intercourse. The report showed that substantial numbers of young women aged from 13 whilst “voluntarily” participating in a first sexual experience felt ambivalent or negative about it (Abma, Driscoll and Moore, 1998). It is reasonable then to conclude that this lack of control reduces the likelihood that contraceptive vigilance will be observed.

Where there has been an unsatisfactory father/daughter relationship the girl may seek to compensate for the lack of love (perceived or real) in sexual encounters. In reality she may be seeking her father’s love and approval. Many will enter relationships where there is a significant age difference. In the U.S. study just referred to it was also found that a relationship with a large age discrepancy (where the partner was seven years older or more), “works against contraceptive use” (Abma, Driscoll and Moore, 1998 p. 17).

Some women can be lacking self-esteem and look to motherhood to find love and success. They unknowingly become pregnant to try and reassure themselves they are worthwhile – that they have achieved something. They want to give the child the love they perhaps didn’t have in their own childhood. It can be a way of them experiencing love for themselves through the baby’s responses.

Lastly we consider:
Self-Punishment and High Risk Behaviour.

Adolescent sexual development often involves a certain amount of risk-taking as has been mentioned before. Sexual behavior can be influenced by “other problem behaviours” such as alcohol and drug use according to a 1998 study (Kowaleski-Jones and Mott). This study looked at the impact of risk-taking behaviours and the presence of depression, low self-esteem and a decreased sense of control in its participants who engaged in early sexual activity. Drugs and alcohol can severely compromise both the control of sexual activity and contraceptive vigilance.

Where self esteem is low a greater vulnerability exists. Reserves are down and so the ability to withstand pressure to participate in “at risk” behaviour is compromised. Particularly where there has been a history of deprivation or abuse a tendency to perpetuate the status quo may be reflected in self-destructive activities.

An unplanned pregnancy can usually place enormous restrictions on the individual, especially the teenager. Plans and goals are thwarted causing disarray and turmoil. Irrespective of the choice in dealing with an unplanned pregnancy the girl is led to the point of making a decision that will impinge dramatically on her life. Continuing the pregnancy, she faces the responsibilities and difficulties associated with pregnancy, childbirth and child rearing often with little access to help. Alternatively, if abortion is the choice, she may interpret the heartache that may follow such a decision as her due punishment. She may feel unable to access assistance to deal with her grief or may believe that she does not deserve help because of her choice.

A study by Stock, Bell, Boyer and Connell in 1997 reported a number of features in those with a history of childhood sexual abuse.

It found participants:

• Were more likely to have had intercourse by the age of 15
• Had not used contraception at the last intercourse
• Were more likely to have had more than one sexual partner

They emphasized the association between sexual abuse and teenage pregnancy due to resultant high-risk behaviour.

Several other studies cited within this report showed that in the general population of women, 60 – 80% incidents of abuse occur before 11 years of age, while 20 – 28% occur in adolescence. Studies of adolescent parents and pregnant teenagers in this report cited young mean ages at the time of first molestation. Maltreatment of any kind has been increasingly implicated as a strong factor in adolescent pregnancy.

Survivors of sexual abuse may accept some level of aggression in intimate relationships as appropriate or normal. These women “may be prone to sexual or physical victimization by others especially in sexual/romantic relationships (Briere, 1992).

When “Nicole” found herself pregnant her partner, “Darren”, insisted that she have a termination. She was very distressed as she wanted to continue this pregnancy and felt she would be able to manage with support. Her partner, however, was adamant and threatened to withdraw from the relationship.

Nicole came for a number of counselling sessions in an attempt to withstand the pressure her partner was putting on her. Even though he was a very aggressive man Nicole had stayed with him for a number of years. She previously had a number of failed relationships (all to dominant males) and felt unable to start again with two children.

Her background story was a sad one. She had experienced a family life affected by an alcoholic and violent father. Her mother bore the brunt of the father’s drunken rages and was often unable to offer her children the emotional protection they needed. She bowed to the father’s demands in order to keep some sort of peace. This affected the family profoundly

Nicole’s current relationship mirrored much of her childhood experience. Darren was a dominant controlling man whose behavior affected both Nicole and their children profoundly. She felt helpless in the face of his aggressiveness and she gave into his demands in a vain attempt to keep the peace just as her mother had done before her.

At times things were more settled which created a false sense of security. It was in the quieter periods that Nicole would hope that Darren might have at last changed. However, that hope was usually short-lived. It was after a recent argument that Darren was particularly remorseful and no contraception was used at his insistence.

This was not the first time that had happened. She had already had two abortions in this relationship and didn’t know how she would cope with another.

A recent study (Olenick, 1999) found that women who had experienced any type of abuse or dysfunction were significantly more likely than those who had not to have had an unintended first pregnancy. From this study researchers estimated that one in five first pregnancies during adulthood were associated with childhood experiences of abuse or household dysfunction.

So many of these pregnancies end in abortion.

One would have to wonder whether anything could actually be considered more self-punitive than having an abortion. In order to do so a woman may have to de-humanize her baby, preventing any attachment to her child. This is something that is almost impossible if she already has other children or has always seen having children as a part of who she is. She has to deny not only the baby but also part of herself. Therefore she has to destroy a part of herself.

The sacrifice of her former value system may, initially, seem like a secondary issue in the light of the pressures influencing her to “choose” an abortion. However, as time passes the woman is often undermined by this very issue – being left with a sense of having abandoned her formerly held views and feelings of guilt and self-loathing.

Major Life Events

Other events that seem to be associated with an increased risk of pregnancy are:
• The beginning or end of a sexual relationship in which sexual contacts are particularly unpredictable
• Where the person has been geographically mobile
• Just before or after marriage
• After a recent pregnancy
• Just after a decision to stop having children
• During menopause (Miller cited in Abernethy, 1980)

Men and Problem Pregnancy

Men are probably influenced in much the same way as women towards parenting unplanned pregnancies. For example the mid-life crisis may lead a man to prove his manhood precisely because he senses it waning. Hardly any research has focused on the role of men in pregnancy proneness, but clinical experience of our therapists at Open Doors shows that family background issues are also critical for men. The situation of men being involved in unwanted pregnancies seems to be consistent with the patterns stated for women.

Conclusion

Many of these factors mentioned above are all too evident in the clients we see at Open Doors. In particular, many younger clients are disadvantaged and, therefore, vulnerable finding it difficult to control sexual activity to prevent a pregnancy from occurring. Numerous female clients, both adolescents and those older, have histories of loss, deprivation, poor self-esteem, a lack of confidence and the ability to be assertive in relationships.

The pregnancy prone woman is often prone to making abortion her immediate response. An unplanned pregnancy for many can represent a very real threat to a woman’s sense of self. She perceives the pregnancy as a threat to her very existence - a “death of self”. Personal survival will often propel her to choose abortion as a means of survival. It is often considered the least of 3 evils – i.e. the choice between continuing the pregnancy, relinquishing the baby for adoption or having an abortion (Swope, 1998).
However, in the words of Germaine Greer, “a choice is only possible if there are genuine alternatives” (1999). She refers to abortion as “an ordeal” that is presented to the woman as some kind of privilege. This, unfortunately, is a by product of our so-called modern “liberation”.

The presentation of a client with a suspected pregnancy certainly calls for action to help with the immediate dilemma. But, however, it can also be expected that the presenting problem is often not the only problem but just the tip of the iceberg and that there may be many issues lying beneath the surface. These, if not dealt with adequately, can continue to pose an unconscious influence on the woman’s reproductive role.

All too often the post abortion woman can then find herself in a repetitive cycle of loss and grief. This involves, in the first instance, unconsciously attempting to cater for unmet emotional and psychological needs and secondly having to deal with the “disaster” that an unplanned pregnancy can represent. If she terminates she then again confronts her vulnerability and the drive to replace the loss.

In the interests of better counselling we need to not only deal with the immediate problem of an unplanned pregnancy. We also need to be mindful of, and address, the unstated and often unconscious influences that may propel girls and women into a pattern of repetitive destructive behaviors.

As counsellors of these women we aim to assist the woman to become more self-aware and self-determining. By being helped to recognize her unmet needs and losses and by being supported to manage them appropriately she is more likely to come out her current crisis functioning at a higher level.

References

Abernethy, V. Unwanted pregnancy: A psychological profile on women at risk. In J.T. Burchaell (Ed.), Abortion Parley. Andrews & McMeel. New York. 1980.

Abma, J., Driscoll, A., Moore, K. Young Women’s Degree of Control over First Intercourse: An Exploratory Analysis. Family Planning Perspectives. Volume 30, Number 1, January/February 1998. Pp. 12 – 18.

Australian Bureau of Statistics Births. 3301.0. 1998.

Bennett, D.L Adolescent Health in Australia - an Overview of Needs and Approaches to Care. A health education and promotion Monograph. The Australian Medical Association. Sydney. 1985.

Briere, J.N Child Abuse Trauma. Theory and Treatment of the Lasting Effects. Sage Publications Inc. 1992.

Condon, J. Unrealistic ideas cited over teen pregnancies. Dr Weekly. 1994.

Kowaleski-Jones, L., Mott, F Sex, Contraception & Childbearing Among High-Risk Youth: Do Different Factors Influence Males & Females? Family Planning Perspectives. Vol. 30, Number 4, July/August 1998.

Fact Sheet 8, Teenage Pregnancy 1995 The Center for Adolescent Health. Royal Children’s Hospital, Melbourne, Victoria 1995.

Greer, G. The Whole Woman. Random House. Australia. 2000.

Hoffman, S.D. Teenage Childbearing Is Not So Bad After All… Or Is It? A Review of the New Literature. Family Planning Perspectives. Vol. 30, No. 5, Sept/Oct 1998. P. 239.

Human Services, Twenty-Ninth Annual Report. South Australia. 1998.

Kiernan, K.E. Hobcraft, J. “Parental Divorce During Childhood: Age at First Intercourse, Partnership and Parenthood.” Population Studies, 51: 41 – 55, 1997 cited in Family Planning Perspectives, Vol. 29, No. 5., p.240 – 242, 1997.

Lamb,D.H. Loss and Grief: Psychotherapy strategies and interventions. Psychotherapy, 25, No. 4. 1988

Olenick, I. Women Exposed to Childhood Abuse Have Elevated Odds of Unintended First Pregnancy as Adults. Family Planning Perspectives. Vol. 32, Number 1, January / February 2000

Parliament of South Australia Second Annual Report of South Australian Abortion Reporting Committee, 2004

Raphael, B. Psychological aspects of induced abortion. Mental Health in Australia. 5., (1), pp. 14-25. 1972.

Stock, J.L; Bell, M.A; Boyer D.K; Connell, F.A; Adolescent Pregnancy and Sexual Risk-Taking Among Sexually Abused Girls. Family Planning Perspectives Vol. 29: 200-203 & 227, 1997.

Swope, P. Abortion: A Failure to Communicate. First Things. No. 82 (April, 1998) U.S.

Twist, S Teen Mums look for love, drift into pregnancy. The Australian. Feb.1994

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3. INTERVIEW WITH THERESA BURKE IN HOBART by Penny Edman
Abortion needs to be re-defined
(with kind permission of Catholic Religious Australia. Full article at catholicreligiousaustralia.com)
pathways, OCTOBER 2007

The abortion issue needs to be redefined from a women's issue to a relational issue according to the woman who developed the Rachel's Vineyard retreat for healing after an abortion.

Dr Theresa Burke who has been in Australia on a flying visit for the Project Rachel National Conference in Sydney said that it was a relational issue as abortion caused a profound wounding at the very heart of a couple's intimacy and sexuality.

It is in this context that men are welcomed into the Rachel's Vineyard psychological and spiritual journey for healing after an abortion. They attend on their own, with their partner and sometimes with a partner who has had an abortion from a previous relationship.

"I like to think of it as a therapy for the soul because it integrates the psychological impact and wounds and grieving process with the spiritual aspects of that traumatic loss," Dr Burke said.

"A lot of women and men believe at an intellectual level that God forgives them, or has the capacity to forgive them, but they can't forgive themselves. And consequently people will go to confession hundreds of times ...

"What is really required of healing is to grieve the loss so there is room for the grace of the sacrament. That requires some work; some reflection on the memories and how you really felt about it.

"Most feelings about abortion are just stuffed away and people don't deal with them and that gives rise to every kind of problem you can imagine."

The two-day retreat model began as a 15-week support group more than 20 years ago.

"It is so painful for people to go back and remember," Dr Burke said. "And if you have a two hour meeting or a one hour counselling session you just start to open it up; you just start to feel it intensely - and time is up and you have to go back and function. And as a result most people didn't complete therapy that they started because it would become too painful.

"The benefit of the retreat is that it allows the person to enter into the grieving and remembering process without any interruptions."

She describes the theological framework for Rachel's Vineyard as "traveling the Paschal Mystery of your own life": travelling the passion, the death and experiencing the loss and the grief and the death of your child, the death of yourself that many people experience in a very profound way and journeying with Christ through to resurrection.

"Christ comes to forgive us, to heal us, to redeem us - that's the good news. And Rachel's Vineyard is to help people experience that good news in ways that are completely personal and unique to their situation, their history, their losses and their trauma."

Dr Burke said that people generally wanted to hide their pain - not only from their friends and family but also from God.

"We can have histories that seem somewhat unredeemable. People try to compensate by creating a public persona (through which they) try to prove to God that they are worthy, instead of allowing God to heal and redeem their wounds. As a result of that there isn't an integrated sense of self.

"I believe programmes like Rachel's Vineyard really help to bring the two together because we are not all perfect, we're human beings . God knows that we sin ... We're all part of a suffering, sinful humanity.

"I think when you go through healing you can diminish the need to be perfect and elevate the part that feels so unholy, bring them together and experience your humanity in a richer, fuller, more whole way that doesn't require hiding and putting on an act."

As the demand for Rachel's Vineyard retreats continues to grow - it is now in 17 countries around the world - Dr Burke has turned her energies towards sexual abuse. In November, she will conduct the last retreat in a three-year pilot programme in relation to sexual abuse.

Grief to Grace will integrate spirituality and psychology for victims of abuse, including clergy abuse.

"I think there's benefit in bringing together those who have been victimised by clergy and those in the general population who have been abused by fathers, and uncles and neighbours because I think it expands the perception of who and what a victim is. And I think a real value in that."

But even as the final nuances are being added to Grief to Grace before it goes public, Dr Burke has another dream.

The next programme will be for veterans of war.

The connection she sees between abortion and abuse and surviving war is the reconciliation required to restore the parts of a person's humanity that is lost through any death.

"God, I believe, would want to restore anyone to fullness.

"These programmes, offering beautiful, trauma-sensitive processes that understand the need to grieve and recognise the pain, are supported by teams of ministers who identify with the journey."

Dr Burke was in Australia for the first time at the end of September as the keynote speaker at the national conference at Chevalier Centre, Kensington (Sydney), on September 29-30. She also delivered public lectures in Melbourne, Hobart and Sydney.

Theresa Burke is the author of Forbidden Grief - The Unspoken Pain of Abortion and her husband, Kevin, a clinical social worker, has co-authored Redeeming a Father's Heart.


Rachel's Vineyard retreats which welcome women, men, couples, grandparents and abortion providers, will be held in Sydney, Launceston, Melbourne, Adelaide and Canberra before the end of the year. These and 2008 dates for Sydney and Brisbane are available on the Project Rachel website.
for further information: free confidential number: 1800 063 510 or email info@projectrachel.org.au

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