When You Can't Turn Back the Clock: Counselling After Abortion

Jun 02, 2016

counselling , pregnancy , women

Every woman, or man, who seeks counselling and support after abortion has a unique story, but there are many recurring issues too
Even when abortion feels like the right choice for you at this time, you may experience mixed, complicated and unexpected feelings
If any of the feelings described below resonate with you, find a therapist here

Unanticipated grief, loss and pain

Many experience unforeseen feelings of loss and grief, complicated by others not knowing about the abortion, or knowing and therefore not understanding nor accepting the grief as it comes from choice she, or they, decided to make. Meanwhile the woman herself might feel she has no right to grieve and be torn between wanting the pain to stop and being unwilling to alleviate the pain in any way as she feels she deserves to be punished. Both the pain and the beliefs about punishment can foster self-harm. Suicidal thoughts are often present too and suicide risk has been shown to be significantly greater for women post-abortion.

Disbelief, anger and regret

Women will often express searing regret about their actions, or inaction, that led to the abortion/s, and at the same time be confused about how they got there. Beliefs about themselves and others may be shaken or shattered so that nothing seems the same afterwards. Rumination and harsh self-criticism can set up a vicious cycle of deeply unhelpful thoughts and harmful behaviours, including substance abuse.

There is very often anger and resentment, at themselves and any others involved. That anger may emerge almost immediately or after years, and can undermine the very relationship the abortion might have been supposed to save. Anger can also be directed at the abortion providers or anyone the woman turned to for advice when, afterwards, she feels she was misinformed and let down, which can also feed into the vicious cycle of self-blame, criticism and feeling ‘stupid’ for accepting that advice.

Trauma or acute stress

There are often symptoms of post-traumatic stress: intrusive, distressing images, thoughts, memories, flashbacks and nightmares, accompanied by avoidance, detachment and anger among others.

Medical abortions have given rise to women seeking help sooner rather than later, often within days or weeks rather than years or decades, as they experience the abortion procedure in a more immediate way and often find they can’t unsee what in the end they have seen.

Anxiety and depression

Anxieties about other children, future motherhood, relationships, being able to cope with everyday situations as well as panic attacks are all reported, as are low mood, low self-esteem and deep sadness.

Anniversaries of the abortion procedure and the due date, subsequent pregnancies, childhood milestones, Mother’s Day, Father’s Day, pregnant family and friends, babies and prams can all trigger memories and distress.

All of this can take place with next to nobody close by knowing that the abortion ever happened, potentially reinforcing feelings of being very much alone. It can be a heavy burden, even heavier for some than others.

Counselling after abortion

The safe space provided by the non-judgemental acceptance in counselling can really help women and men to allow themselves to grieve, to explore and express all the mixed and painful emotions they might experience and to examine and restructure any unhelpful thinking or behaviours.

CBT interventions useful for other post-traumatic stress can be really helpful here too, for example, skills training for relaxation and emotional regulation, exposure to the traumatic memories and cognitive restructuring.

Sometimes it is valuable to explore the beliefs about self, others and the world, even formed in early childhood, and the role they can play in adult relationships, behaviours and decisions, to help gain an understanding of how the abortion came about. That new understanding can help clients find some peace with the past and light the way to future goals.

Compassion-Focussed Therapy is often most suitable to help those consumed by self-criticism and experiencing shame. Once the foundations have been grasped, and any initial resistance negotiated, it can help people begin to let go of the punishing self-condemnation. As many women say, they can’t turn back the clock, but no woman or man who seeks counselling after abortion is alone, and no matter how heart-breaking their personal story is, there is always hope and help available.