CONTENT WARNING: This story contains mentions of miscarriage, cancer, and workplace bullying, and may be triggering or disturbing for some.
Is my body a temple or a tomb? It’s 4.58am and I am miscarrying for the second time in a year.
I place my hands on my belly in a bid to slow down the searing disappointment coursing through my body. Having walked this road before, I know I’m prone to ‘grief brain’, where cognition, concentration and memory take a hit. Basic words like ‘toothpaste’, ‘bottle’ and ‘there’ evaporate mid-sentence. I am furious at myself for it. One moment you’re in the throes of pregnancy, and next your womb has gone silent. And with death, all the hopes and dreams you had.
“This,” my colleague Michelle said, arms waving about the office after my first loss, “must all seem like such crap to you.” Absolutely, I breathed, feeling strangely seen. On the outside, it was business as usual. Internally, my world was being rearranged within me.
According to Professor Lesley Regan in Miscarriage:What Every Woman Needs to Know, around 80 to 90 percent of miscarriages are caused by chromosomal abnormalities in the foetus. “In humans there must be an important mechanism in the mother’s uterus that helps to limit her investing in the growth of embryos that are genetically and developmentally compromised,” Regan recognises.
It’s curious that a mother’s body silently, in spite of her heart, may determine that a foetus is chromosomally incompatible to life. And while we know that birthing a child with genetic abnormalities is arguably not in the best interests of the child, a part of my spirit is still aghast that my body on a cellular level, tyrannically—naturally—decided for me.
Which brings me to wonder and worry about us women collectively. How many times have our bodies tried to warn us of something amiss within? What about when our bodies feel perfectly fine one day only to blindside us with a devastating condition the next? Of all the profound things our bodies do even without our awareness, how do we cope and heal when things happen to—and within—us?
When life has other plans
Singaporean finance professional and co-founder of Fertility Support SG, Liew Weylin found herself in the chemotherapy chair four days after she was suddenly diagnosed with breast cancer at 33. Like someone tasked to fix a plane while flying it, processing her new-found fear while pinballing from one oncologist to another made for turbulent times.
“You’re so frozen and numb from the onslaught of bad news that you don’t even know what to fear,” Liew, now aged 40, explains.
“When trouble strikes, you almost develop a PhD in this terrible thing that you never wanted to study but find yourself a victim of. You go through this week where your entire life falls apart very swiftly. Each day brings worse news and uncertainty. I had ricocheted from the frying pan into the fire and was feeling a lot of grief, sorrow, an incredible amount of fear and regret.”
If loved ones were cheering you on before, just wait, because the ‘rah-rah’, as Liew describes it, dies down. Once your treatment progresses and supportive friends feel exhausted with caregiver burnout, it can feel as if you’re well and truly alone. As chemotherapy takes effect and your body begins to fail, loneliness and fear then peaks two to three months in “when you can no longer rely on your body faculties and you start to get scary experiences, either tachycardia (where your heart rate stays up fora long time) or another friend’s instance where she blacked out and fell”, shares Liew.
“Those are things that give you PTSD after that and you’ll end up limiting yourself because you don’t want to put yourself in danger.”
What trauma does to the body
In The Body Keeps Score, Bessel van der Kolk writes that recovery can’t begin until one becomes familiar with and befriends the sensations in their bodies. “Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past.”
This feeling of being ‘always on’ is described by psychologists as hypervigilance. It’s exhausting for a body to live on high alert, steeled against every potential threat or trigger.
Eugenia Yee, a psychologist at National University Hospital’s department of psychological medicine says: “It is common for people to experience some psychological distress, including fear, somatic symptoms and sleeping disturbances immediately after experiencing a traumatic event.”
This useful survival technique, Yee explains, is the body’s way of protecting a person from experiencing a similar harrowing or dangerous experience in the future. However, Yee cautions, if a person’s psychological distress persists, “they can face difficulties processing the traumatic event and their bodies continue to respond as if they were still in the dangerous situation. These individuals may struggle to experience positive emotions, avoid situations and people, and feel as if they are still stuck in the traumatic event.
In other words, the body remains in a heightened state of arousal, constantly looking out for danger.”
Liwen Zhang, a 31-year-old advertising manager, still reels from the aftermath of leaving a toxic workplace where stress—both chronic and acute—triggered an irregular, racing heartbeat alongside terrifying palpitations. “My body broke down; mentally it was just a living nightmare,” says Zhang, a once conscientious employee until her health was pushed to the brink by bullying and hostile team dynamics. Before even getting out of bed, her heart raced as if she ran a marathon. “I thought it was a stress-related anxiety attack and saw a cardiologist as my heart rate just wouldn’t slow.”
Constantly pounding at a dangerous 140bpm, Zhang was diagnosed with hyperthyroidism, with her cardiologist sharing that her body was on the verge of a thyroid storm—“a potentially life threatening complication of hyperthyroidism”.
Zhang says her metabolism went crazy and despite eating a lot more than usual, she lost 10 percent of her weight. It also had a domino effect on her cognitive processing. “I had brain fog and had difficulty remembering things. This was especially scary as I typically have quite a decent memory. I felt anxious. My brain would not switch off and it was hard to find true rest,” says Zhang, who then sought the help of an endocrinologist to help rebalance her hormones.
Regaining body agency
After survival comes the task of re-establishing ownership of your mind, body and self. “There are so many aspects to learning how to trust your body again,” notes Liew after the decision to undergo a double mastectomy. “My whole world was cancer, cancer, cancer. And at that age, who wants to talk about that with you? I realise that very few people can sit with ‘sad’ and grief. Either people don’t know what to say or other people process your reality faster than you do.”
“I have said to many women that it takes one year to heal your body and three years to heal your mind. And I do stand by that,” Liew affirms.
“Even so far as trusting your body again, will you ever walk into an examination believing truly that you will be fine? I’m now six to seven years out of diagnosis and I generally walk in feeling nothing but that there will be ‘scanxiety’.”
“Even then the healing process is very dynamic,” continues Liew, addressing the complex recovery journey and challenges for young cancer survivors specifically. “There’s the physical recovery of your body—not just scars but aches and pains. It’s a mental recovery as much as it is physical. Many younger women have yet to make decisions about dating relationships, fertility, career, family, these are then all impacted by disease. Slightly older women who go through this with responsibilities to their young families: it’s really hard too… as much as it makes you pull yourself up for the sake of others, it means you delay actually processing your own emotions. And it comes in ways that can be very messy.”
Speaking of messy, Yee shares that trauma is often accompanied by feelings of shame, which explains why it’s unsurprising for people who have undergone traumatic experiences to find it difficult to talk about their emotions. Take the general shroud of silence around pregnancy loss or domestic violence, for instance.
“This also means that there are fewer opportunities to process the trauma and build a stronger sense of control,” says Yee. “The body continues to be on high alert and remains stuck in the survival mode, which can be emotionally and mentally exhausting.”
If you’re finding it hard to open up about your journey, know that everyone has their own timeline. “Trauma can lead to avoidance of people, places and activities. Take baby steps to reconnect with the things that are meaningful to you—spending time with loved ones, going to places you enjoy, engaging in your pastimes and hobbies,” says Yee. She also recommends seeking help from a “mental health professional who can provide a suitable evidence-based treatment to help you work through your traumatic experience” when you’re ready. Feeling safe in your body again involves much more than doctor’s visits and therapy.
For some, it can also mean ruthlessly editing your life and letting go of what no longer serves you. As Zhang wasn’t able to immediately quit her toxic workplace, she sought ways to lessen interactions with her co-workers. This distance buffered negative situations that arose and offered her the space she needed to process and deal with events objectively. She then began practising yoga and leading a healthier lifestyle, paying more attention to her mental health.
“If you feel like something’s off, see a doctor—don’t wait and try to deal with it in hopes that whatever symptoms you have might disappear.” Zhang’s mindful approach included self-care days, surrounding herself with an “amazing support system”and prayer before she eventually gained the courage to leave after realising things wouldn’t change or improve. “I reframed my mindset and learnt to see that leaving was not losing. Instead, I was proactively taking steps to better my environment and situation.”
Yee shares that the key lies in acknowledging and making room for your difficult emotions as they arise. “Ground yourself and come back to the present moment, rather than staying stuck in the memories associated with the trauma. Engage your five senses using the 54321 method—name five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste. Go to a safe space (be it physical or imaginary) and remind yourself that you are safe here and nothing can hurt you.”
Will you ever come to feel at peace or less adversarial with your body again? “Maybe you’ll come to a level of acceptance. Denial is not a terrible thing. Paranoia is not a terrible thing—if controlled, it probably makes you a better parent. Feeling like only what happens now is valid, it’s not a terrible thing in so far as it leads you to lead a more experiential life,” Liew muses.
“Making new memories because you can’t remember the past is not a terrible thing. There’s an emotional, psychological reckoning that goes with that physical recovery. We need to have better support and language to address that, I channeled part of my recovery energy into helping create a support group to mentor diagnosed young women at the Breast Cancer Foundation.”
“I look back and think, ‘Maybe you never get to a point where you fully reconcile what has happened to your body and mind and your experience, but you get to the point where you own your story’,” Liew muses. “And maybe that’s the most important part.”
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