Dear Lisa:

Words have certain meanings depending on their context and on the person using them. When a counselor uses words like "trauma" and "grief," one has reason to believe that she is using them with their "professional" meanings in mind.

When an experience is traumatic, it means--professionally speaking--that a person's ability to cope has been overwhelmed. Symptoms may include shock and short- or long-term stress reactions, such as flashbacks, nightmares, intense and debilitating anxiety, hyperarousal, hypervigilance, insomnia, etc. Post-traumatic stress disorder may develop. Given that such symptomatology is part and parcel of trauma, I find it extremely hard to believe that "traumatic" is an accurate description of the children's experiences of seeing a mother nursing her child. Furthermore, it does not make sense that witnessing biologically and developmentally normal human behaviors would be traumatic. The kinds of events that people truly find traumatic involve threats to life and physical and psychological integrity, such as war, rape, violent accidents, assualt, natural disasters, man-made disasters, sexual abuse, brutal birth experiences, etc. This counselor's use of the term "traumatic" does not seem appropriate to me in this context.

Her use of "grief" is a little less problematic to me, in that grief is actually a *positive* human experience. However, the counselor seems to me to be talking about it in an inaccurate way, too. When a loss happens, the grief that follows does not equal the loss. Grief is the normal, healthy, and human process by which people (of any age) learn to live without what they lost. It is also a difficult experience to go through. If the children are grieving the loss of breastfeeding, they should be supported in their experience of grieving. If the parents of the children are grieving the loss of breastfeeding, they should be supported in their experience of grieving. And, if the counselor is grieving the loss of breastfeeding, she should be supported in her experience of grieving.

Exposure to breastfeeding would *not* be the cause of the grief, because exposure to breastfeeding is *not* the loss. Loss of breastfeeding is the loss. Exposure to breastfeeding may serve as a "trigger" for experiencing grief that is "unfinished," however. This triggering can be experienced as a positive thing since grieving is healing. It may also be experienced as a negative thing since the person in that moment may have inadequate resources and support for the difficult experience of grieving well. It is important to know that ungrieved, unhealed losses do not somehow just go away and do continue to negatively impact people as long as they remain ungrieved. (The negative impact of an ungrieved loss of breastfeeding, is not limited to the woman herself. Her ungrieved loss can impair her ability to provide breastfeeding support to others. If the woman is a healthcare provider, employer, legislator, community leader, etc., her lack of support for breastfeeding can negatively impact countless others.) Avoiding triggers of grief may be useful in the short run until better resources and support can be acquired, but may be harmful in the long run because healing from a loss cannot happen without grieving.

I talk about these kind of issues in more detail in my presentation "Loss, Grief, and Breastfeeding Counseling."

P.S. The "CATSM" behind my name means "Certified in Acute Traumatic Stress Management." I'm also a member of the American Academy of Experts in Traumatic Stress (www.aaets.org) and have an MS in clinical psychology. 

Hoping something here is useful,

Cynthia

--
Cynthia Good Mojab, MS clinical psychology, IBCLC, RLC, CATSM 
Ammawell 
Website: http://home.comcast.net/~ammawell 
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