Discover an eye-opening conversation with Dr. Kara Davey, a clinical psychologist and ADHD coach, who shares her heartfelt journey through ADHD and perinatal trauma. Dr Davey opens up about her own experiences with perinatal loss and the profound ways these events magnified her ADHD symptoms, ultimately inspiring her to establish two businesses dedicated to trauma support and ADHD coaching. Her unique perspective, grounded in both professional expertise and personal experience, underscores the profound value of empathetic, relatable support from someone who truly understands what you're going through.
The episode also sheds light on broader issues, such as the disparities in psychological support for men following perinatal loss and the pressing need for better support systems in healthcare. Dr Davey touches on the heavy emotional toll faced by midwives and mental health professionals in perinatal loss services, highlighting the critical need for comprehensive psychological support to prevent burnout.
This is a must-listen for anyone seeking more profound understanding and practical tools for navigating the intersection of ADHD and trauma.
Dr. Kara Davey About Kara
Dr Kara Davey is a clinical psychologist passionate about helping adults with ADHD. Kara is a trauma specialist with extensive perinatal training who understands how ADHD presents in both men and women, including how hormones, difficult life events and times of transition impact ADHD symptoms across the lifespan. Kara has ADHD herself, diagnosed after the traumatic stillbirth of her middle child, she also two has children with ADHD traits too. So, she knows the impact of ADHD on everyday life personally, too.
Kara understands that most adults with ADHD have never been taught the skills to thrive in a neurotypical world and is passionate about sharing the tools she has learnt personally and professionally to help other people benefit from them, too. Kara uses a wide range of evidence-based strategies to treat all factors contributing to a person’s challenges while also maximising the person’s strengths to help them improve both functioning and quality of life.
Some of the approaches Kara draws from to increase coaching effectiveness include Cognitive Behavioural Therapy (CBT), Eye Movement Desensitisation Reprocessing (EMDR), Compassion-Focused Therapy (CFT), Acceptance and Commitment Therapy (ACT), Emotion-Focused Therapy (EFT), and Dialectical Behaviour Therapy (DBT).
Services
Kara provides a range of ADHD services, including-
NICE compliant ADHD assessments for adults,
ADHD coaching to improve executive functioning; coping skills; communication skills; emotional regulation and/or productivity.
Executive coaching for Senior Leaders
Business coaching for ADHD entrepreneurs.
Therapy, specifically tailored for adults with ADHD, including EMDR (trauma therapy), which can be exceptionally effective at improving emotional wellbeing and mental health given that so many ADHD’ers experience trauma in their lifetimes.
Corporate Webinars
Line Manager Training
Consultation with HR professionals, managers and/or individuals wanting support to implement reasonable adjustments in the workplace.
Kara accepts Access to Work funding and is registered with insurance companies to provide both ADHD assessments, therapy adapted for ADHD, ADHD Coaching and coping skills training.
Links to find out more and access my free resources
Discover an eye-opening conversation with Dr. Kara Davey, a clinical psychologist and ADHD coach, who shares her heartfelt journey through ADHD and perinatal trauma. Dr Davey opens up about her own experiences with perinatal loss and the profound ways these events magnified her ADHD symptoms, ultimately inspiring her to establish two businesses dedicated to trauma support and ADHD coaching. Her unique perspective, grounded in both professional expertise and personal experience, underscores the profound value of empathetic, relatable support from someone who truly understands what you're going through.
The episode also sheds light on broader issues, such as the disparities in psychological support for men following perinatal loss and the pressing need for better support systems in healthcare. Dr Davey touches on the heavy emotional toll faced by midwives and mental health professionals in perinatal loss services, highlighting the critical need for comprehensive psychological support to prevent burnout.
This is a must-listen for anyone seeking more profound understanding and practical tools for navigating the intersection of ADHD and trauma.
Dr. Kara Davey About Kara
Dr Kara Davey is a clinical psychologist passionate about helping adults with ADHD. Kara is a trauma specialist with extensive perinatal training who understands how ADHD presents in both men and women, including how hormones, difficult life events and times of transition impact ADHD symptoms across the lifespan. Kara has ADHD herself, diagnosed after the traumatic stillbirth of her middle child, she also two has children with ADHD traits too. So, she knows the impact of ADHD on everyday life personally, too.
Kara understands that most adults with ADHD have never been taught the skills to thrive in a neurotypical world and is passionate about sharing the tools she has learnt personally and professionally to help other people benefit from them, too. Kara uses a wide range of evidence-based strategies to treat all factors contributing to a person’s challenges while also maximising the person’s strengths to help them improve both functioning and quality of life.
Some of the approaches Kara draws from to increase coaching effectiveness include Cognitive Behavioural Therapy (CBT), Eye Movement Desensitisation Reprocessing (EMDR), Compassion-Focused Therapy (CFT), Acceptance and Commitment Therapy (ACT), Emotion-Focused Therapy (EFT), and Dialectical Behaviour Therapy (DBT).
Services
Kara provides a range of ADHD services, including-
NICE compliant ADHD assessments for adults,
ADHD coaching to improve executive functioning; coping skills; communication skills; emotional regulation and/or productivity.
Executive coaching for Senior Leaders
Business coaching for ADHD entrepreneurs.
Therapy, specifically tailored for adults with ADHD, including EMDR (trauma therapy), which can be exceptionally effective at improving emotional wellbeing and mental health given that so many ADHD’ers experience trauma in their lifetimes.
Corporate Webinars
Line Manager Training
Consultation with HR professionals, managers and/or individuals wanting support to implement reasonable adjustments in the workplace.
Kara accepts Access to Work funding and is registered with insurance companies to provide both ADHD assessments, therapy adapted for ADHD, ADHD Coaching and coping skills training.
Links to find out more and access my free resources
Excellent. So good morning everyone. I am Laura Spence, also known as the ADHD Midwife and founder of Neuronatal. Today I have with me the lovely Dr Cara Davey and I'm really excited to this conversation because Cara herself has ADHD and does quite a lot of trauma work around perinatal loss and other things and I believe you also support, um, some supervision and healthcare professionals and I will hand over to Cara and just let her do a bit of a brief introduction on what she does, how she does it.
Speaker 2:
um, yeah, take it away, cara thank you, laura, and uh, yeah, thank you for inviting me on. So yeah, as you said, uh, my name is cara davey. I'm a clinical psychologist and also an adhd coach. Um, so I essentially run two businesses. Um, I have a therapy business called cara clinical psychologist in sussex and we specialize in supporting people with trauma, and many of those are bereaved parents who've experienced loss in pregnancy, after loss, or even kind of older children. And then I have a separate business, dr Davy Coaching, which is predominantly supporting people with ADHD for ADHD coaching, executive coaching, business coaching, transition back to work any of those things business coaching, transition back to work, any of those things. So, yeah, so there's a big, big kind of crossover between ADHD and loss, but they are kind of two separate businesses. That certainly keeps you busy, hey.
Speaker 1:
It does indeed. And what is? You have yourself a diagnosis of ADHD, do you?
Speaker 2:
I do indeed. Yeah, so the reason even though the two businesses sound quite different to lots of people, I suppose I am the kind of the the link, the link between those. So just to say a little bit about me, kind of personally. So, yes, I have a diagnosis of ADHD that I received in adulthood, but that was after a difficult fertility journey including five miscarriages and a stillbirth, and so after the kind of trauma of my own fertility journey, that's where I started specializing supporting other people with loss and later on, after doing a lot of work to kind of support myself, I was like why are things still not like they used to be? And actually the missing bit for me was ADHD and that the trauma had essentially exacerbated the ADHD. And that was when I found out about ADHD and started the second business. So the link although they seem quite random to some people, the link for me was that the trauma exacerbated the ADHD so much that that was something I've become really passionate about supporting as well.
Speaker 1:
Gosh, I'm really sorry to hear about your your experiences. Um, that must be really difficult, but actually I can imagine it must be quite um cathartic to now be working with lots of um families and people who have been experiencing similar things. And and actually those clients that you're working with must take a lot from the fact that you've also been through similar experiences to them and that you can really relate, because it's not often that you necessarily get a therapist or a coach who can relate so much to your own personality.
Speaker 2:
Yeah, absolutely yeah. So I'd been working in the NHS for about 10 years when I had my stillbirth and I was already specialising in trauma. So I was in a specialist trauma service. I'd been there for six years I think. So I was doing a lot of work of supporting people through a really difficult life event and their whole life kind of falling apart or changing in an instant, and helping them to kind of rebuild the pieces.
Speaker 2:
And then, of course, when the stillbirth happened, for me that was, you know, I was like, okay, this is a similar kind of process to I've been supporting other people with. I kind of knew how trauma goes and what would kind of help with that and I kind of instantly, you know, actually I'd really like to take this trauma knowledge that I already have and take it into perinatal psychology because, as you say, there's less people who've experienced that themselves and who are open about their own experiences and saying, actually, yes, I really want to support other people and so, yeah, that's kind of why I do that. And a lot of the clients who come to see me will say that perhaps they've seen somebody else first who haven't experienced loss and they don't feel that it's kind of understood or got in quite the same way. So often that's how people will end up kind of of seeing me all the time.
Speaker 1:
Well, that's amazing, cara. Well done. That's a. It must feel like really fulfilling work to be in that field. Um, you talked a little bit there about um how your your own trauma um exacerbated your ADHD symptoms. Can you expand a little bit on that around that manifested?
Speaker 2:
yeah, absolutely. So, you know, for a lot of people who are late diagnosed, the signs were perhaps there but not picked up by other people for a long time and I would very much, you know, relate to that. If I look back at school reports it'll say Cara must learn to think, think before she speaks. I did a lot of lines for speaking. Yeah, there were absolutely signs there kind of earlier on. But I was lucky enough to have found a job that I really enjoy and had enough scaffolding that the ADHD wasn't causing me as many problems as it has done for a lot of other people. So I was kind of blissfully unaware of it, I suppose, even though when I read about it I was like oh okay, probably should have known sooner.
Speaker 2:
But yeah, when I experienced my loss, for me it almost felt like I had a brain injury and I knew I hadn't had a brain injury. There was nothing about my loss that would you know, kind of cause that. But the cognitive kind of executive functioning challenges of ADHD exacerbated so strongly for me and I knew, I knew the theory that trauma can exacerbate executive challenges. I knew the theory that grief can exacerbate cognitive challenges. But there was something kind of plus plus about it and even when I sought out trauma therapy for myself to make sure I'd really process my loss before I kind of help other people with it, so I and I knew that emotionally I was fine, I was supporting people with it all the time I was like this isn't trauma and this isn't kind of acute grief anymore, but there is something cognitively that just wouldn't shift and all of the kind of the forgetting things, the losing things, the kind of classic kind of executive struggles, yeah, just suddenly, from nowhere, they were just part of my daily life all of the time in a much more exaggerated way than they ever had been before, and I just couldn't make sense of why that was the case until finding out more about ADHD.
Speaker 2:
And then I was like, okay, it's literally like someone that there was a kind of underlying simmering fire of ADHD and I'd got used to that and lived my life. And then when I had my loss, it was like someone poured petrol on it and you know the flames and I was like, wow, like I cannot, I cannot get back to the simmer of the fire, no matter what I do, and I know a lot of strategies and theory to be able to help, but I just can't get there. And it was the yeah, so it was very much. You know. My understanding is that the trauma switched the ADHD genes on further exacerbated those challenges and I've had to work really hard and do a lot of coaching and find other ways now to manage that because as much as I've processed the trauma, I can't completely get rid of how much those genes have been turned on.
Speaker 2:
It's you know, that's part of life for me now. Well, and that must be.
Speaker 1:
How old were you at that point, cara?
Speaker 2:
So I was 34.
Speaker 1:
Okay, and that's when you got the diagnosis yeah, it was a few years later.
Speaker 2:
So, my lot, I was 34 when I had my loss and then, yeah, it was a few years later before I really kind of even though I trained as a psychologist and learned about ADHD when I trained 15 years ago, it was still the training was on children and still naughty boys in class, type kind of presentation really of ADHD.
Speaker 2:
So yeah, it was a few years later when I was trying to make sense of it and I was quite sure it wasn't grief and kind of trauma anymore and I processed everything that you know people had said all my life that I had traits of ADHD. Like my mum had worked in a GP surgery and she was like, oh, all these letters about ADHD, these look familiar. So you know, kind of even my mum, even my mum had highlighted it and I'd kind of dismissed it. And then I started reading about it and I listened to a podcast by another psychologist. I was like, wow, she could be talking. She was talking about her own ADHD. I was like that could be me and then that was the point that I joined all the dots. So, yeah, that was a few years later. I think I was 37, um, by the time I, which is the same age I was, which is a very common age, isn't it?
Speaker 1:
for females? I think 37 is the the average age now for a female diagnosis, which is, you know, it's great that we're recognizing it, but it's still really sad that it's you know, it takes a lifetime of struggle before, yeah, absolutely getting to that point. Um, I I wonder if you could explain, just for the listeners around. Um, I can hear the kids coming up the stairs a bit at the moment. Who's mum on the, who's mum on the phone too? Um, I wonder if you could explain, just for the purpose of the listeners and actually for me.
Speaker 1:
Um, around, the kind of emotional dysregulation that comes along with adhd, that kind of um for me, a lot of the time I experience, I would say, emotions that are out with the context of the situation. So you wouldn't expect somebody to have such an emotional reaction to a certain event, but I seem to, and certainly depending on the time of the month that it is. Um, I seem to have quite an extreme overreaction that lasts for some time. Anytime I replay that situation in my head, I get really worked up about it, and it takes some weeks before that. Obviously, I recognize that as rejection, sensitivity, but how does that all kind of feed into your emotional dysregulation or emotional regulation?
Speaker 2:
Yeah, so we know that people with ADHD tend to have more sensitive nervous systems. So it makes us great health professionals. You'll find a lot of health professionals with ADHD, because we tend to be more empathic and very kind of great at being able to support other people. But we do tend to have that more sensitive nervous system which can be that, you know, blessing for others but also a bit of a curse for us. We feel deeply and strongly and you know that intensity of emotion can be harder, harder to regulate. Alongside that, as you've mentioned, there's rejection, sensitivity, dysphoria, but also, you know, we know that children by the age of 12, a child who is neurodiverse or with ADHD, tends to receive about 20,000 more critical comments from teachers, parents, peers than someone who is neurotypical because their behaviour isn't quite fitting with you know how everyone else wants them to be. Therefore, there's these constant kind of criticisms and often people are dismissed. You get a lot of what we call little t trauma. So it might not meet the full criteria for post traumatictraumatic stress disorder, for example, but this repetitive kind of trauma response, this repetitive kind of message of you're not good enough, you're not normal, you're different, why can't you behave like other people. You know this kind of it's not good for self-esteem at all and adds to this kind of sensitivity and we start to be more critical ourselves. We start to be more critical ourselves and you know it's harder to regulate if someone is constantly telling you you're being wrong or you're too much or you're. You know, if you've got a sensitive nervous system you react quite strongly. People around you don't like that reaction. It's harder for them to regulate, so they tend to, instead of sitting and kind of calming you down in a way that they might.
Speaker 2:
You know a child who's got a more kind of regular reaction. You know a child who's got a more kind of regular reaction. What you tend to see is people start to get annoyed or angry and you know kind of be dismissive, back to that emotion which feeds it and you know it's a really difficult cycle then because you know what we know is helpful. You know if you think of a small baby when they cry, the instinct is to soothe that baby and you know then they will be okay.
Speaker 2:
But if you've got a child who's got a sensitive nervous system, they're upset by their environment, whether it's sensory, whether it's, you know, kind of anything around them and they're dysregulated and you have someone being you know kind of being stop that. Or you know you'll have lines or you'll be told off or there's a punishment or someone who kind of shouts. Then it stops people being able to regulate and if other people don't teach us to regulate, we can't regulate for ourselves. And then you might also have a whole bank of what we call the little t trauma, so lots of kind of traumatic events, and we know that trauma again exacerbates how dysregulated the nervous system is. So there's a kind of really difficult balance and cycle that goes on.
Speaker 1:
For a lot of people with ADHD that means it is just really hard to be able to regulate and just only gets harder in time as those kind of experiences add up and I guess as well, taking into account historically it being a kind of male focused condition that we potentially are dealing with a lot of unregulated, undiagnosed mothers who are parents, and that probably plays into that reinforcement of that trauma, because mum or dad may have, um, you know, reduced tolerance, um, and quicker reaction times, I guess, and then perhaps that's been the same since they were children and it all kind of feeds, feeds in, doesn't? It's a bit of a vicious cycle really. So, um, I wonder, what kind of um, what kind of strategies would you recommend I feel as if it's turning into a free session for me now Cara recommend for a mother like me who is essentially quite, um, dysregulated? I mean, I'm certainly getting better. So it's over 18 months since I've been diagnosed. I've been on the medication. For that length of time I've not had an alcoholic drink since I started my medications. I'm very well behaved. I would much rather have my medication than have to sacrifice the medication in order to have a drink, because I just don't think it's worth it. Um, but I'm also on the you know the full whack of sertraline, propranolol, um, but I do still find sometimes it all feels a bit out with my ability to cope.
Speaker 1:
I have a daughter who's 15. She has has ADHD, autism, all of the associated learning disabilities, physical health conditions. We live on an island where we don't have any family support, which was probably not the wisest. If I knew then what I know now, it probably wouldn't have been. You know the recommended choice, um, but what kind of coping strategies would you be recommending, um, in terms of how to manage you know these situations a bit better to try and prevent that escalation of your emotions and yeah, I think, as you said, I think first of all it's important to acknowledge that often if you've got one person with ADHD, there is probably not just one person with ADHD.
Speaker 2:
They are more likely not always, but more likely to be married to a partner with ADHD or autistic traits and you know you've got a roughly 50-50 chance of having a child who also then has you know kind of neurodiverse traits or a kind of a diagnosis. And then you know you've probably then got a link with your own parents where there's some neurodiversity, perhaps unrecognized or undiagnosed kind of there as well. So often you've got this really difficult cycle where it's not just one person who you know kind of has more intense needs or has had those kind of difficult life experience. You've got a whole cycle and you're trying to regulate yourself, your partner, that relationship, children, you know kind of family, etc. So you know there's a real mixing pot of difficult emotions. So that's the first thing to say in terms of emotional regulation. I mean, that varies a lot between different people. Like I think that's why it's so helpful to kind of meet with someone and learn more about their history. But just to say first of all, if there is trauma in someone's background and we'll talk a bit more probably in this about trauma. But essentially, if someone experiences trauma, coping strategies will only ever help them to cope with the symptoms of trauma. But essentially what is happening if you have trauma symptoms is the brain is saying this memory, this difficult memory or this difficult event hasn't been processed at the time because it was too difficult for the brain to cope with. It's therefore not done the full processing of moving it into your memory and filing it away as it should do. And therefore those trauma symptoms are essentially saying you need trauma therapy to be able to process it and if you don't have trauma therapy to process it, the symptoms are going to continue, no matter what strategy you use. So the first thing is, you know, I can, I can list some strategies in a moment, but whatever strategies you use, if it's unprocessed trauma, only processing the trauma is going to get rid of those symptoms. Otherwise you're just constantly trying to manage the symptoms and as soon as they are, you know, kind of brought back up by another situation, they're going to be re-evoked again and you're going to be fighting to re-regulate. So I think that's important to say. But in terms of strategies I mean the strategies for emotional regulation are similar whether you have ADHD or whether you don't have ADHD.
Speaker 2:
However, what I would say is for a lot of my clients with ADHD, movement might be really helpful addition or they might be kind of tweaked. So we know that if, when our nervous system is dysregulated, essentially what is happening is we're in that fight flight mode, you know our adrenaline is running around the body, our heart rate's higher, so regulating that is really important by kind of doing breathing. It might be that the temperature helps. So for a lot of people, if your emotions are really intense before even trying to breathe, because you're probably too, too dysregulated to even go there, then it might be that holding ice or splashing your face with cold water is a really good like temperature kind of shakes the body out of kind of that intense emotion. There may be kind of some running on the spot or something to get rid of some other pent-up adrenaline, because you know your body wants you to fight the lion or the tiger or you know the fight flight response is like go fight or run away, and if there isn't something to run away, sometimes we need to get that energy out of our body, especially if you're someone with combined type adhd, is already quite high energy. If you're then full of adrenaline as well, you're going to probably need to burn that off and then you're more kind of calming strategies, of you know kind of breathing or, um, you know a lot of.
Speaker 2:
There's a lot of talk about mindfulness, which is great for long-term coping with adhd, but really hard for us adhd is to do and and certainly not one to be doing in the moment. But but generally, what I would say to people is, if they want to practice more mindfulness as a kind of long-term thing to help with kind of impulse control etc. Then try to adapt it to kind of mindful movement, so it's not sitting quietly and trying to, you know, just notice your breathing. You're probably going to find that too tricky. Why not go for a walk in nature and try and notice the different colors around you? Or, you know, adding in a bit more kind of movement. Or, you know, mindfully brushing your teeth so you can focus on what you're doing. Or someone with ADHD tends to just need it adapted a little bit, because otherwise they're going to beat themselves up for the fact that they're really trying and they can't
Speaker 2:
yeah, absolutely so. Visualization could be a good one. So remembering a time when you felt particularly good about yourself or a time where you've been able to nurture someone else or someone has been able to nurture you, or you know, kind of remembering something so you get a real feeling in your body where you can kind of tap into it. That can be helpful having a physical box of things you find soothing. So whether that's got a stress, stress ball in it, whether it's got a taste you like maybe a little square of chocolate or a strong taste like mint, it might be, um, a scent you really like. So it's really grounding to have.
Speaker 2:
If you find a particular smell you like, to kind of smell that you can have it on a handkerchief, that can kind of bring us back, um to to you know, kind of back to kind of ourselves more quickly. So there's lots of strategies that we could recommend, but it would depend a little bit on the situation and what's happening. And then alongside strategies there's also looking at thoughts. So you said kind of, you know, when I think about it it kind of revs it up. So that's the case for a lot of us. Essentially, we can feed dysregulation by going over the thoughts really ruminate on it and punish yourself over and over and over yeah, or.
Speaker 2:
Or feed anger at other people because we're annoyed at what they've done, or. But you know, sometimes when we're going over these things in our head, we can really feed those, um, you know, by so sometimes looking for thoughts that would help our coping. So it doesn't matter if it's true or not true, necessarily it's about what would help me cope right now. So is thinking about it helpful for me or is it revving it up like what would what would help me right now? So sometimes thinking about our thoughts can be kind of a really helpful way. Um, for asking for help is a great one if you have that situation.
Speaker 2:
I know you were saying, you know for you you haven't got help around. But you know, especially for people if they've experienced a loss, for example, um, you know, being able to, a lot of ADHDs don't want to ask for help. We might not have got very helpful responses from others or it might be quite hard to reach out and ask for help. But being able to ask for help, sometimes when things are really tough and we're struggling, being able to say, okay, this is hard, actually I could, I could do with some support, if that is available can be a really, really helpful thing to do.
Speaker 2:
So I think it's a mixture. And then the other thing would be just giving yourself permission to be dysregulated or upset by something and then being compassionate to yourself instead of beating yourselves up, because those those critical voices we hear as children repeatedly tend to become our own critical voice and we tend to be quite harsh to ourselves, which again can really feed it I should be able to cope better, or I'm over exaggerating repeatedly tend to become our own critical voice and we tend to be quite harsh to ourself, which again can really feed it. I should be able to cope better, or I'm over exaggerating, or we can really you know, kind of feed it with beating ourselves up yeah, gosh, that's really interesting.
Speaker 1:
I've just had a penny dropping moment there around. I'm very aware of the the inner critic narrative that goes on, um, and I'm getting better at quieting it down. But just when you've said that there, I've put two and two together. That actually where does that narrative come from? And of course, it's all of those negative, that sequence of negativity that you've had growing up, whether that's from teachers or peers, um, of course, then you adopt that, um, that little critic that lives inside your head. I've never really thought about the process of that before, but that's been a real penny dropping moment for me there.
Speaker 2:
Thank you no worries, yeah, it's very normal that we internalized. I mean, that's how children learn everything. It's how we learn to talk, it's how we learn to walk. We look at what other people around us are doing, saying um and kind of take it on board.
Speaker 2:
So, yeah, it's really really common that our inner voice is a combination of those around us and if that's been more positive and supportive, then you know that's really helpful to us in life. If that hasn't been the case, then you know we're more likely to have that criticism ourselves. And of course, the mistakes that people make in ADHD make us more self-critical as well, because we're like, oh, why have I forgotten my keys again? Or you know what, why, even though I'm working on that thing, why have I still lost this? Or you know kind of um. So yeah, I think that adds to the critical voice as well.
Speaker 1:
Yeah, it's huge, isn't it? And actually, in terms of, um, the clients that you support, I can imagine, then, that that's kind of magnified tenfold when, um, when they're experienced whatever type of loss they have had, I can imagine that that, um, that client who has both been experiencing a perinatal loss and the trauma that comes along with that, as well as whatever traumas they've had previously in their life that they're bringing, as well as any kind of neurodivergent potential diagnosis that they have, that all kind of it must be really difficult to manage and navigate. And actually, would you agree or disagree that people, then, who are neurodivergent are far more likely to experience kind of perinatal related trauma?
Speaker 2:
yeah, I think. I mean it's hard to say. I think for a lot of people who experience loss it is traumatic, like we know. You know, I think the Tommy's figures are that a third of all miscarriages um tend to result in PTSD and that's kind of PTSD, not just trauma symptoms, that's. And then of course there are more traumatic types of loss. There are some loss that last longer, um, when I say more traumatic types of loss in terms of actual trauma happening at the time, as well as not just the emotional trauma of the loss, because any loss can be, you know, kind of emotionally traumatic, but there can also be physical um you know kind of trauma in the birthing process or you know kind of helping baby pass, etc. So yeah, there's a lot of kind of trauma that can be inherent um in a loss anyway, and I think you know loss pretty much universally can be traumatic. There's a lot of people who come and see me who would benefit from at least some kind of trauma work as part of it.
Speaker 2:
But yes, I think if you're neurodiverse, sometimes there is also, you know, we know that what can be difficult in a birth or in a loss in the health care system is if someone doesn't feel understood, they feel dismissed, they feel not listened to. You know, there's not just the the physical trauma, it's also the relational kind of trauma and if, if you think of what we've been talking about with ADHD, if someone goes in with reduced movements, for example, and a healthcare professional says, oh baby, seems fine, discharges them, and then they come back and they have a loss, then you know that can really feed into that the person's guilt that they should have put, you know, kind of pushed harder. They're kind of an earlier narrative perhaps of this constantly being dismissed, being told they're too much or they're exaggerating. So, yeah, I mean, whenever you're experiencing it, whenever I'm working with someone who's had a loss, you've got to take into account their kind of history.
Speaker 2:
Again, they might have been someone who, because other people have dismissed them, didn't want to speak up and they didn't go in soon enough to hospital or they, you know, perhaps delayed a little bit longer because they thought, well, maybe I'm being silly or I over exaggerate things, or yeah, they completely doubt themselves and if they have a loss then they really beat themselves up for for that, or so yeah, there certainly are factors from, you know, previous trauma, relational trauma and things that are more unique. Um to people with neurodiversity. That compound um the perinatal loss experience and how traumatic that can be. Um. But yeah, I think for anybody who experiences loss some of those factors can be there too.
Speaker 1:
But yeah, of course there's a lot of things in common, aren't there, between um neurotypical and neurodivergent people, but I think, in that sense that sometimes it can, there are certain elements of it that just magnify it and make the experience um a bit more hard-hitting, certainly absolutely.
Speaker 2:
And sometimes you find people with ADHD tend to be very busy doing lots of things and again there can be a sense of regret if they hadn't been checking on movements, because they were like I was just so busy, I was rushing around life is kind of busy and then you know, kind of realized, well, maybe I should have, you know, maybe it would have been helpful if I'd have realized there hadn't been as much movement earlier or so you know, sometimes I see that in people who are neurodiverse. But yeah, it's so incredibly difficult and you know, the likelihood is, even if they'd gone in that little bit earlier, then you know it, probably, you know, probably wouldn't have changed the outcome. But you know, guilt is huge for any bereaved parent and I think but I think just to say a little bit about the difference between guilt and shame so guilt is when someone says I really wish I'd done something differently. And with hindsight and with the information I have now we can, you know, we can understand a lot of bereaved parents would say actually I really wish I'd, you know, acted differently or you know, kind of.
Speaker 2:
But I think what we tend to see a lot in people with neurodiversity is because of the, the kind of histories that we've talked about in the relational. Sometimes they switch from guilt to shame. And I'm a bad person, I'm an awful person, I enabled this to happen. Well, um and it, and we know that shame is so much harder to deal with and so much more emotionally dysregulating and and damaging and, you know, in terms of our own self-esteem and our ability to cope. It's so much harder if we're then, you know, kind of really attacking ourselves and saying it's not just this thing, I did that, I wish I'd done differently. It's me as a person who I dislike and I think you can see that a little bit more with people who've had that kind of difficult history, potentially alongside neurodiversity, which is really really tough and something I work, you know, really hard to help people with, because it's, you know, it's so hard to cope with loss anyway without that added shame.
Speaker 1:
Yeah of course, and in terms of so, do you work with um mainly the mothers who have gone through the loss, or do you do you do any work alongside the fathers or as families? Or how does it work if you have other members of the family that are traumatized by it as well?
Speaker 2:
yeah. So I mean, often after a loss, people will come to me as a couple and they will have sessions together as a couple and then we might look at, okay, who might benefit from individual work, or is it just that you want a space together to think? I think that's something. Really a lot of the people who come to see me are those who won't qualify for an NHS service because they are, I suppose, not meeting the thresholds. They're not considered severe enough that they are able to access an nhs service and yet, of course, how they are feeling emotionally, just because they can function to other people, um, you know, doesn't mean that they don't, you know, kind of wouldn't benefit from a service. So I do see a lot more dads than I think services would. Most services don't see dads and therefore actually I end up seeing a fair number of dads who just wouldn't qualify for an NHS service. So we seek that out privately or, as I say, they might come as a couple and then, you know, kind of sometimes I end up seeing both partners because it's clear that trauma work would help both partners.
Speaker 2:
I think you know, just to say that dads or partners can absolutely be traumatized by the loss as much as you know, as mums and females can, because they are witnessing, you know, not only have they lost their child in the same way, but also sometimes they are powerlessly witnessing this really difficult event play out, where, you know, not only are they losing their child, sometimes mum's health is in question or they're seeing, seeing, you know, an incredibly distressed partner and you know sometimes the process of grief, the order of grief, can be a little bit different. Sometimes men focus a little bit more on women and they tend to be a bit more emotionally expressive. So mums tend to grieve kind of immediately and dads might take that more supportive role and then, as mums start to kind of be able to regulate some of that distress a little bit more or have moments where the grief is less intense, then sometimes you see kind of men's grief come out and sometimes that's really hard because that's when men will reach out for help, because they'll say, oh, now my partner seems to be doing a bit better. And you know, actually this is really hard for me, or they've been. You know they don't.
Speaker 2:
Men don't receive the same level of um leave as women do. So if you have a loss after 24 weeks, then a woman is entitled to a full year's maternity leave, whereas men they will. We might have two weeks paternity leave or a month's paternity a very short amount of time. So often for men they go back to work and that's the point that the grief hits. So they might then reach out to me and say, oh okay, like now, I don't know how to cope with this. So I certainly do see women, men and families.
Speaker 1:
So, yeah, it's not just female kind of partners who will reach out or will be affected, you know, in a trauma way by loss and and it's really sad actually, isn't it that this is 2024 um, and there's a huge expectation, I think, on men and fathers now to be present and to be there for the partner and to witness all of these things that go on, whether in terms of um, childbirth or the process that happens with baby loss, but yet there's, there's kind of not really much of a an avenue of support for them, um, yet we still have the expectation that they'll they'll be there, um, which is not fair, of course, um, and almost it feels to me as if it should be. That kind of psychological support should be an opt-out. You don't feel that you need it. It should. It should be an automatic thing that you are linked in with someone, never mind about the thresholds, but surely prevention of it or learning how to manage it is much better than you know, in all senses of the word, for your relationship, your economic situation, housing all of those things.
Speaker 1:
It's going to be far beneficial to mitigate it than wait until people are at crisis point. It's quite frightening really, isn't it, and I understand the services are overwhelmed. Yeah, however, I think somebody needs to be looking at it with a more holistic pair of specs, don't they and think actually it might not be as overwhelmed if we could just mitigate for these things in the first place. Yeah, absolutely.
Speaker 2:
I mean, there has been funding. It's only in the recent years that we've started to develop what we call maternal mental health services and it's again a bit of a postcode lottery as to who gets what. But there is funding that's been kind of put into birth trauma and perinatal loss so that more people are able to get a service. Um, and within that the problem is in each area it's up to the individual locality to decide how they use that funding. So some people have expanded that to include partners and the hope is that that will come, that they will be rolled out to kind of all services that you know partners will be included more. But the reality is at the moment a lot, a lot of services haven't reached that point yet or because of funding, they only have enough funding to go as far as they can.
Speaker 2:
Different people have decided to prioritize different things and often the more intense the symptoms then you know, obviously they are people who are prioritized more. But it means those who are what we call the worried well or those who are coping well to other people, despite how distressed they might be, you know, kind of under the surface, don't get that service. But yeah, I completely agree, it would be better if it was, you know, kind of offered to everyone, and I think that a lot of the local baby loss charities are trying to fill that gap. So I know certainly I'm based in Sussex and I'm also a trustee for Oscar's Wish baby loss charity, which is a local Sussex based charity, and certainly we offer as standard the bereavement midwives will offer six sessions of counselling with Oscar's Wish to everybody if they want it. So it is very much. Uh, it's the bereavement midwives will say do you want it? And you know people can opt in at any any time or so.
Speaker 2:
It is more of that case, I think. But again, six sessions is, you know, a start point and we're just trying to look at bringing in trauma therapy as part of that rather than just counselling. But different areas are doing it in different ways, but we're plugging a gap because there's only so much services can do. And I guess that's why, you know, as you said earlier, I support health professionals as well. It's why I've kind of expanded to not just supporting individuals and families, but I also go into kind of corporate workplaces and provide kind of line manager training and you know, kind of how can we help employers to better support? Because actually there's a lot of employees who are not receiving that support or it's not available on the NHS.
Speaker 2:
So, you know, do they know how to get that support? Do employers know how to support them? Do they know, you know, those with private health care insurance if they're in a corporate role? Do they know they can ask for specialist support, you know, via their kind of health insurance? And then I also go to health professionals and say, if we better support health professionals affected by loss and provide kind of training to health professionals so they know how to support, then of course you know people are going to have an easier experience of that. So I'm very much try to deal with the whole system as much as possible because I recognize those gaps are that you know the NHS can only can do what it can do with the funding that's available hugely, and I think that's a really important thing to touch on.
Speaker 1:
Is that, um, as as you said when we we first started talking, that the caring profession probably does attract quite a lot of neurodivergent individuals?
Speaker 1:
Obviously, my background is in midwifery and I can imagine that there are high percentages of undiagnosed midwives, um, albeit and I mean, the profession is dominated by females, isn't it?
Speaker 1:
98%, I think, of the midwifery workforce are female and I think, given the amount of midwives I've come across over the span of my career, I could pinpoint several midwives I think would benefit from a an assessment of some form of neurodivergence.
Speaker 1:
But also, we do carry a lot of trauma. We tend to be those really empathic people who lack boundaries around what you're bringing home you tend to absorb, and not just the trauma you know that's unfolding with the woman or the family that you're looking after, dynamics of working in that environment where you're dealing with quite a lot of dysregulated people or a lot of traumatized people who are channeling that in a very negative way and it all becomes a little bit toxic, or they're bullying other people or whatever that situation might be. But you're kind of getting it from all sides then, as this wee midwife that's dealing with all this and kind of perinatal loss or the emergencies that happen within those situations, to then dealing with other staff members and colleagues, it all becomes really quite a traumatizing situation. And if you don't have the ability to regulate yourself emotionally or to be able to cope with those things and you can get burnt out very easily, can't you?
Speaker 2:
Yeah, absolutely, and it is a really difficult kind of cycle. So I support kind of mental health professionals working in loss services, but I also support bereavement midwives, screening midwives, consultant midwives, people who are doing kind of investigations from perinatal loss and kind of services. So a lot of different midwives. And yes, I see a lot of people who are telling me that they are neurodiverse or I see traits, whether they're you know talking about it or not. But also when I go into hospitals and do training around baby loss, one of the things I say is you know, it's so difficult for individuals, you know for mid, because what we know helps bereaved families more than anything else is, you know, high levels of empathy, being really supportive, being, you know, kind of absolutely there for someone, which a system doesn't always allow you to do from a practical point of view because of time and resources.
Speaker 2:
But also, if you are able to do that and a lot of neurodiverse people will, you know a lot of people with ADHD do that incredibly well and are very attuned. That's brilliant. But when I kind of get to the end of the training, I say, okay, let's look at the impact on you as a health professional. What we also know, as you said, is the rates of burnout, of compassion fatigue, of being traumatized by other people's, seeing other people's trauma, compassion fatigue of being traumatized by other people's seeing other people's trauma, etc. All of those things are, you know, the. The chances of those are much higher if you are really high in empathy. So it's brilliant for those around you, but for your own well-being it puts you at a kind of higher risk of being affected by your work sorry, I'm just getting distracted by the children.
Speaker 1:
No worries, they're fighting over. There's a sheen parcel. That's just arrived. Sorry, that's all right. I know it's for me. Can the two of you stop fighting and get out my room off? You go, but they're just so nosy they cannot help themselves or your children well, mine?
Speaker 2:
no, they're not allowed anywhere near my office because it's just not appropriate when dealing with loss. So no, they're not, but I have to. They're younger and so I have to make sure they've got other childcare.
Speaker 1:
They've just money. At school today ripped open my sheen parcel sorry, we were and I really I was really involved in what you were saying there and the bloody doorbell went.
Speaker 2:
It's all right um, yeah, so I was just saying it's really hard for well-being, essentially for middle-aged, because actually what you're doing for other people is brilliant, but we know that also puts you at higher risk of burnout. And and it amazes me actually that when I go into support teams there's very little a understanding that we can become secondary traumatized as a, you know, as health professionals, by supporting other people. Um, but be just generally training for emotional regulation, supporting yourselves. Like you know, a workplace has a responsibility. If you're in a job where you're more likely to become burnt out or traumatized, they have a responsibility to also be supporting you with appropriate supervision, training etc. And yet so many services will pay for me to supervise.
Speaker 2:
But if I say, oh, what about training for emotional regulation and kind of supporting and improving staff resilience? Oh, we haven't got the funding for that, which amazes me because that's how you end up with so many staff going off sick and burnt out and in the in the long term it pays for itself. But it's also a responsibility of an employer to take care of people emotionally if you're putting them in a position where they are more exposed to distressing emotions than they would be in everyday life and I mean that that's one of those things that I'm really passionate about and I find that it really ignites that justice drive within me that I think that is completely unacceptable.
Speaker 1:
That, you know, I've been a midwife for nearly 13 years and very little psychological support has been offered across the course of my entire career, even when I have asked for it, and you know the amount of traumatic things that I might have faced across the course of that time is is phenomenal, um, but yet you know they'll. They'll give you the telephone number for the employee assistance scheme. Well, great thanks, but that's not exactly what I had in mind. But it needs to be better. It's unsurprising that, um, the maternity systems in the uk in fact probably globally are in the condition they are. They're so short of midwives because we neglected this whole time. Um, I read a frightening statistic that for every cohort of 30 newly qualified midwives that come out of university ready for registration, you're only really gaining one. Because of the rate, for every 30 that qualify, there's 29 that are leaving.
Speaker 2:
Yeah, I mean that tells you that the system is broken, doesn't it?
Speaker 1:
yeah, yeah, absolutely 100. And then there's all these um maternity reports and investigations that obviously come out now on a weekly basis it seems, and then also midwifery council that whole report that came out last week. It just it strikes me that, um, I mean, I know providing that psychological support is not the be-all and end-all, but I think it certainly would be a good starter for um helping to retain all of those really experienced midwives. Um, instead they're just hanging them out to dry, really, and get on with on with it.
Speaker 2:
Yeah, it makes a huge difference and, as you said, it's also about the system. So, you know, the psychological support is really important, the ongoing, you know, kind of support, the training in the first place, so people feel like they know what they're doing and how to respond. All of those are important. But then also just generally feeling supported by management, feeling acknowledged, like all of those things are hugely important, because sometimes I see services who are willing to pay for me to come in and support their staff, but what I'm hearing again and again is how difficult the system is around and it's kind of, oh, let's forget about the system, just go and talk to the psychologist about it and then that makes it all okay. Well, there are, there are multiple levels of support and the individual support is really important.
Speaker 2:
But also just looking at the kind of um, you know the system and and how that's acknowledged. So, yeah, I think midwifery is an incredibly tough profession to to be in and I think there's a lot of pressures. And, as you say, you know the media doesn't help, because I think sometimes it is then very much about individual midwives or services rather than recognizing the huge problem that exists, and you know it's much more systemic than being about individual. You know, of course there will be cases where something might be about an individual, but on the whole it's normally something much bigger in terms of the system.
Speaker 1:
It doesn't happen in isolation, does it? It's always multifactorial. Not many things in life happen just independently, exactly, and the thing is it's probably true for health care right across the board. It's just that there seems to be a huge focus at the minute on the kind of maternity related things, but once we start to scratch the surface, it'll become apparent that it's the whole system. That's. Yeah, I think you're doing such important work in terms of, you know, supporting families, parents that are experiencing perinatal loss, all your trauma work all around the ADHD and neurodivergent stuff, as well as obviously supporting health professionals and bereavement midwives. It's such important work. Thank you very much for you.
Speaker 2:
Thank you for your service, cara, and thank you as a midwife and to all the all the other midwives out there. As I say, I think it's a uh, a profession that's hugely difficult and I almost always said it's interesting in a way that I've ended up in this area. I always said if I wasn't a psychologist, I'd be a midwife, like I think it's, you know, I think it's a, you know, amazing to be able to support women at such a vulnerable and difficult time of their life, whether they have a loss or whether a you know, a child is born healthily, it's still, you know, incredibly vulnerable time.
Speaker 2:
So I think it's an amazing professional and, yeah, and I very much will say to the you know professionals that I work with often, you know, thank you for all you do, because it's really, really important yeah, and I think we forget that.
Speaker 1:
Because you're kind of in that acute setting as a midwife, you know whether it's, um, just one episode of care that you're providing to that person, but you have the ability to really make or break that experience, because we know a lot of it's based on those relational interpersonal communications and how people are made to feel when they're under your care, and even a short episode of care can have such far-reaching effects, whether that's positively or negatively. So, um, it's really important to recognize that.
Speaker 2:
But, yeah, I mean it comes up a lot in therapy. Just you know generally the experience that someone had when they were told you know if we're going back to kind of loss. You know the experience someone's told if they go to a scan and they find out, or you know kind of how they are supported at the time of their loss or after. And you know kind of during that birth process it comes up a lot in therapy for both good and bad reasons, obviously, depending on the circumstances. It comes up a lot in the trauma workers.
Speaker 2:
You know, kind of during that birth process it comes up a lot in therapy for both good and bad reasons, obviously, depending on the circumstances. It comes up a lot in the trauma workers you know being really difficult. And then also that is often the moment it's interesting because when I train midwives a lot of people will say, oh, it's really hard because I might become teary or you know, kind of be moved by someone's. And yet in therapy actually they're normally the moments where people are touched by it in a positive way and they'll say I knew that midwife cared like. I saw the tears in her eyes, I saw how much she wanted that for me.
Speaker 1:
And there's no harm in that is there. It shows that you're forgiven and that you know I feel so sad for you and it's absolutely fine. Certainly in my experience it's fine to you know you don't want to distract from from that family's grief, but also to show that you're affected by that. I think means so much to the people that you're that you're caring for.
Speaker 2:
It's huge, absolutely. And those things again can really help with coping afterwards to know the person who looked after me really cared and, you know, did their best.
Speaker 1:
That empathy is so important yeah, and tell us how can? How can we get in touch with you? Do you have a website? And follow you on social media?
Speaker 2:
I can put the handles um into the comments of the show, but if you let us know how yeah so yeah, so, as I say, I have two separate businesses so I have a link tree set up for both businesses so I'll share the link, but one the the baby loss kind of support, is, um, always in my heart and we'll share the link. And then there's also one Dr Davey ADHD coaching. Um, so some people will fall under you know, kind of a bit of both. Some people come for coaching and then actually have therapy or vice versa, but, um, yeah, on the whole, either of those link trees will. Well, there's lots of free resources for both, but especially for baby loss, I run free monthly support groups for people who've lost a baby.
Speaker 2:
I also run after that another group for those who are pregnant, again after loss. So they're kind of monthly support groups over Zoom after loss. Um, so they're kind of monthly support groups over zoom. And then there's free handouts on coping after loss, things to give to family members or employers to help them with supporting after loss. There's videos to understand what is it? You know, have I experienced trauma? Might I benefit from trauma? Or so if you go to the linktree, there's lots of different things that people can access. There's also a form I've devised for people who, when they're going back into services, maybe in a pregnancy after loss, and they've had a loss that they might write and give to professionals as a brief summary of how you might help me in my care. So we're kind of what I want professionals to know.
Speaker 1:
They need to revisit it all and retell. This will be a hundred times.
Speaker 2:
It's yeah what I found when I've done training is some of the sonographers can't even access the maternity notes, so sometimes they don't even know someone's history when someone's coming in. So if you have a brief note that you can hand in reception when you go to an appointment, it means the sonographer can briefly read those notes and they can be more sensitive to the person in front of them rather than asking questions that are quite triggering with without knowing um. So yeah, all sorts of resources like that. They're all on the link tray, so I'll provide the links and you could, yeah, if you could share that with us.
Speaker 1:
That'd be awesome. Thank you so much, absolutely. I'm just gonna stop the recording.
