Breastfeeding Aversion and Agitation (Aversion)
On Guilt and Shame
As mothers who experience BAA will know, there is a sudden wave of shame and guilt that follows the intrusive thoughts and negative embodied emotions of aversion they get while the infant is latched and feeding, especially if a mother has to de-latch the infant. So, it is important to look at these emotions in greater detail to better understand what it going on in the phenomenon of BAA. We have looked at anger on the previous tab, and we will look at depression on the next one. Here, we cover shame and guilt, which often go hand in hand.
What is guilt?
Guilt can be defined as a feeling of worry or unhappiness due to having committed an offence or even thinking that you have done something bad or wrong (Tangney et al). People can also feel guilty for thinking or acting in a particular way that is contrary to the beliefs of friends, family or the society, or in this case what a breastfeeding mother thinks she should feel. The portrayal of the 'happily in love breastfeeding mother' is rife in every picture seen, from UNICEF to the NHS, it's always of a smiling breastfeeding mother. Breastfeeding triggering feelings of anger, agitation or disgust are not what any mother expects to feel. Intrusive thoughts like being 'desparate to leave' while nursing, 'wanting to throw the baby across the room', or even just disliking breastfeeding are just not ever really portrayed, let alone openly spoken about. It is not surprising that a mother would feel guilty for feeling negative emotions that breastfeeding causes her to have. We know what already from the phenomenon of Dysphoric Milk Ejection Relfex (or D-MER).
What is the point in guilt?
Loosely, evolutionary theories and social psychology theories give many explanations for the causes of the 'guilty' feeling, and the reasons why we may need to feel guilty. Looking at these briefly may help us understand more why a mother feels them. Evolutionary theories hold that people often feel guilty for causing harm to other people. Mothers who experience BAA often need to de-latch a feeding infant, and/or have limits set or 'timed feeds' for toddlers and older children, or flatly refuse, and although this in itself does not 'harm' an infant directly (if over 6 months), mothers who breastfeed often know of the great benefits their milk can provide, and by denying their infant of it a mother may feel guilty. Guilt has a role in teaching us how to forgive. The same theories suggest that demonstrating remorse or regret afterwards is a beneficial factor for relationships in general because it is this that makes forgiveness possible (Tangney et al).
According to social psychology theories, people often feel guilty for not helping out a person who is suffering (Miriam L. et al., 2013), here in the breastfeeding dyad an instance might be the infant/child crying because the mother refuses to breastfeed at that particular point in time. So, failing in her efforts to assist the suffering infant/child often results in feelings of guilt (Often the only assistance will be to 'give in' and offer the breast). These feelings of guilt are more prone to people who have high levels of empathy, and who are also likely to suffer from anxiety and depression, so this may tie in with post-natal depression. Other theories hold that the root cause of guilt is actually due to social processes or societal expectations of mothers, such as how mothers should experience parenting, expectations to return to work, how children should behave, and how they should not breastfeed for extended periods (especially in the Western world).
How to manage guilt?
There are various ways of managing guilt, some of these, including ecognising the kind of guilt that someone has and its purpose; making changes as soon as the purpose of guilt is recognised; accepting that a mistake was done and deciding to move on; learning from the mistakes made, and recognising that no person is perfect. This is very hard to do in this situation, because in BAA mothers are often locked in a viscious cycle of rationally wanting to breastfeed, the infant/child 'depending' on it, and the movewhelming emotional or biological urges to stop when the infant/child is latched. Therapists play a vital role in helping people to learn how to accept responsibility for their actions and put their guilt into perspective, and this may help a mother with BAA, things like Cognitive Behavioural Therapies or Psychosocial Interventions are typical things therapist try. They can also help those individuals who feel guilty of the percieved or actual wrongdoings by making them understand that they were/are not the cause of the trauma, or seeing things in a realistic light.(Averill, 1983). A person can reach a point where they can be liberated from any negative effects of guilt and shame in their lives, esentially if they free themselves from feelings of blame (which often come just before the feeling of guilt).
What is shame?
Shame is an emotional feeling of guilt, with self-hate, regret, or sadness that someone experiences because of doing something wrong. It is a painful feeling that arises from the consciousness of having done something wrong, or something percieved as wrong. There are numerous reasons why people feel shame about themselves, and it actually has important roles to play - one is for empathy (Konstam, Chernoff, & Deveney, 2001).
Shame may result from underlying false beliefs that an individual is not loved enough, valued, or even understood because there is something amiss with them. With time in some cohorts of women, this becomes the sole belief as it gives a the women the a feeling of control over other people's feelings or behaviours. Shame is extensively written about and a very complex emotion. (Sanftner, & Crowther, 1998)
Infant feed itself has also been shown to be a shame-inducing event in itself (Thomson et al), regardless of whether you are breastfeeding or bottle-feeding with artificial milk. Developing a sense of shame about your role as a mother may come in many forms and even from other areas of life circumstances like divorce, having physically challenged kids, or job loss may result in extreme behaviours such as addictions and development of eating disorders and self-harming behaviours as an adult (Sutherland A,-J, 2010). And, as an adult that person may fail to meet core needs such as love and intimacy, self-intimacy and maintenance of self-esteem due to the feeling of shame. Studies in women with eating disorders are useful to understand symptoms and descriptions of shame that may be transferable (not clinically) to BAA. (Burney & Irwin, 2000).
What can help?
Well, generally, counsellors and therapists can assist people to overcome feelings of shame through offering objective and healthy perspectives of situations that are causing them to feel shameful. This step may also be helpful for BAA, but as it's not a recognised phenomenon or condition I doubt the therapy would come for free. Shame in the context of BAA may also be managed by accepting that your babies behavior and feeding at the breast triggers negative feelings in you and instusive thoughts, and that it might not be in your control, and so it's your 'fault' so to speak (i.e no blame). When someone accepts that they are not the cause of these feelings, this allows them to move into compassion for themselves as well as for others. It also allows them to let go of their false beliefs ('I'm not a good mother', 'I hate breastfeeding'.'there's something wrong with me' etc) about themselves and that they are the cause of shame. (Miriam, L. et.al, 2013, Harder, & Lewis, 1987).
Uncovering the experiences or feelings that led to shame may also help relieve the feeling of shame too (Sutherland, J., -A, 2010). I've yet to write an article about triggers, and how to figure out your own equation for experiencing BAA, but essentially it will explain how to identify when, how and why aversion happens to you specifically, and what to do about it. It is one step towards the process of accepting that you experience negative feelings, and finding out why in your own analysis. Knowing you are not alone, and that breastfeeding / nursing aversion and agitation is experienced by many, many women is the start of this process. Accepting your feelings the next step.
Consequently, feeling one's authentic feelings rather than covering them up with shame or anger allow a person to free themselves from the feeling of shame (in theory), instead of being 'shamed into anger' .(The emotions of guilt and shame are often inextriblably bound to the emotion of anger). Feeling shame about yourself can essentially be managed by being compassionate about your existential feelings, instead of protecting against them with shame and guilt, and risking the cycle of anger perpetuating.
Tangney, J.P, Stuewig,J., & Mashek, D.,J., (2007), Moral emotions and moral behaviour. Annu Rev Psychol. 2007; 58: 345–372.
Thomson, G., Ebisch-Burton, K. and Flacking, R. (2015), Shame if you do – shame if you don't: women's experiences of infant feeding. Matern Child Nutr, 11: 33–46. doi:10.1111/mcn.1214
Burney, J., & Irwin, H. J. (2000). Shame and guilt in women with eating‐disorder symptomatology. Journal of clinical psychology, 56(1), 51-61.
Harder, D. H., & Zalma, A. (1990). Two promising shame and guilt scales: A construct validity comparison. Journal of personality assessment, 55(3-4), 729-745.
Harder, D. W., & Lewis, S. J. (1987). The assessment of shame and guilt. Advances in personality assessment, 6, 89-114.
Konstam, V., Chernoff, M., & Deveney, S. (2001). Toward forgiveness: The role of shame, guilt, anger, and empathy. Counseling and Values, 46(1), 26.
Sanftner, J. L., & Crowther, J. H. (1998). Variability in self‐esteem, moods, shame, and guilt in women who binge. International Journal of Eating Disorders, 23(4), 391-397.
Sutherland, J.-A. (2010), Mothering, Guilt and Shame. Sociology Compass, 4: 310–321. doi:10.1111/j.1751-9020.2010.00283.x
Miriam L., Schiffrin, H., H., Rizzo, M., K., (2013) Maternal Guilt and Shame: The Role of Self-Discrepancy and Fear of Negative Evaluation
Journal of Child and Family Studies, Volume 22, Issue 8, pp 1112–1119