The trauma experienced after a miscarriage can be overwhelming. Some women may develop distressing thoughts about themselves and their lives, or isolate themselves, pushing away family members and friends. One form of treatment that may be helpful is cognitive behavioral therapy, or CBT. This form of psychotherapy focuses on a client’s thoughts and behaviors, which can help women heal from their loss in a more effective way. For women who have experienced pregnancy loss, there are three effective strategies used in CBT that can be beneficial: behavioral activation, cognitive restructuring, and mindfulness and acceptance.
Behavioral activation involves engaging in meaningful and enjoyable activities that provide a sense of accomplishment. Women who have experienced pregnancy loss may sometimes isolate themselves, often for fear of having to share the news of their loss. However, by isolating themselves, women may miss the positive social support that comes from interacting with others. In CBT, behavioral activation starts small, with activities that require no planning, before moving on to more complex and value-driven activities. Some of these activities might include traveling to visit family, or volunteering for a cause they are passionate about.
Cognitive restructuring for women who have experienced pregnancy loss involves identifying the thoughts and beliefs that these women have, evaluating their accuracy and usefulness, and modifying them to be more balanced and helpful. These women often have beliefs about themselves and their lives that cause emotional distress, such as the belief that they will never be a mother, or that they are to blame for their pregnancy loss. Cognitive restructuring involves asking questions about these beliefs to help women tease through the accuracy and helpfulness of such beliefs. For example, women may be asked to examine a situation where they felt they were judged by someone for their pregnancy loss, consider the other explanations for their behaviors, and decide for themselves what beliefs are more compassionate and balanced.
Mindfulness and acceptance is also an important factor for women who have experienced pregnancy loss. Women with pregnancy loss will often try to avoid their negative emotions or painful experiences. CBT asks these women to learn to accept their emotions, no matter how painful, and show them that they can still lead a quality life even with those feelings. By focusing on being mindful in the present, these women get out of “autopilot” and can catch the subtle changes or triggers that lead to their emotions.
All three of these strategies are useful in some way to help women who have experienced pregnancy loss to accept their situation, address their emotional distress, and begin to participate in their lives again.
Wenzel, A. (2017). Cognitive behavioral therapy for pregnancy loss. Psychotherapy, 54(4), 400-405. https://doi.org/10.1037/pst0000132
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