Six higher-order themes emerged from the data analysis. Figure 2 summarises the themes identified in the transcripts. This paper focuses on how somatic, emotional and social learning processes facilitate mindful parenting.
Somatic mechanisms
All the clinicians highlighted body awareness as a critical change process. The body scan is a frequently used mindfulness technique, used to increase breath awareness and identify stressors and feelings in the body. The importance of whole-body awareness is a recurring theme. Anna commenced her clinical training in body-oriented psychotherapy. Anna trained parents to read their child’s body language and posture. She trained parents to look at their child’s eyes to identify their child’s needs. Diana described how mindful breathing improves breastfeeding. Bella spoke about a mother with severe depression who was unable to take her medication for restless legs during pregnancy. This mother had experienced interrupted sleep and ongoing aggravation:
She was… responding to the restless legs with a whole lot of judging thoughts about, I shouldn’t have this, and my father had it and I didn’t like my father… the thoughts went around in [a] ...ruminating frustrating way.… as soon as she recognised that, that was the process, she had this aha moment and she was able to drop the judgment that having this unpleasant experience in her body. It became much, much easier for her to tolerate the actual physical experience… she was able to sleep better.
Recognising the habits of the mind was a process the mind frequently engaged in, resulting in the reduction of the physical symptoms.
The association between trauma, neglect and the physiology of the developing brain emerges in all the interviews (Anna, Bella, Cara). Diana described the body as being the “trauma holder.” Likewise, Cara described how the “body keeps score,” mentioning Bessel van der Kolk’s book and Peter Levine’s work on Somatic Experiencing. Bella highlighted how memories of sexual assault often arise during childbirth. Cara illustrated the importance of a “soothing hug” and physical contact as being essential for healthy development. Neglect and the lack of social contact also impair healthy development. To highlight this, Cara provided the example of the “Romanian babies all lined up.” At the end of the Cold War in 1989, images of Romanian orphans lined up in cots caught international media attention. These children were subjected to cold, hunger, sexual abuse, physical abuse and lack of care [34].
The significant language and psychosomatic delays among these orphans later in life have been attributed to the lack of stimulation, physical contact and malnutrition [34]. Hence, it appears that much more than food is needed for healthy development.
The clinicians illustrated how children and parents are particularly affected by the body holding the trauma. The toddler bouncing off walls gradually learned to self-soothe as the mother started looking at her child’s face, particularly her eyes when she was raging. The parent’s restless legs and the labouring mother’s trauma during childbirth highlight how it is equally important for parents to work through physical trauma during the mindfulness program. Table 2 illustrates how clinicians assist parents to acknowledge and release the trauma. Parents with a trauma background often find it difficult to meditate, so the clinicians encouraged them to use mindful movement or focus their attention outside the body on an outside sound or object.
Affect regulation mechanisms
Attachment
Affect regulation mechanisms included secure attachment, emotional balance, attunement, emotional awareness and emotional regulation. All clinicians emphasised the importance of attachment. Bella explicitly emphasised that reflective functioning promotes secure attachment. The others outlined how they explained attachment to the parents. Cara outlines that from the outset parents are provided information on “What is attachment.... how it affects healthy outcomes?” Likewise, Anna states “We provide theory, support and a method to explore and transform attachment styles.” A conceptual map of the attachment, abandonment, developmental needs and how “attachment patterns are generated by your parents” (Anna) were provided to the parents in a non-pathologizing way. “Aversion, attachment and ignorance are predictors of mental illness” (Bella). This perceptive observation by Bella, leads her to comment that the “being state of mind” promotes secure attachment. By drawing on the work of Jon Kabat-Zinn and Mark Williams, Bella articulated,
It’s all about the being mode of mind. I mean being present and aware to your baby...that is the sort of fundamental building block to developing a secure, attuned relationship with your baby. It’s not about doing things to your babies. It’s about being with your baby.
Thus, the “being” state of mind facilitates secure attachment.
Cara stated the “facilitator provides secure attachment,” “a safe haven,” and “secure base” for the parents to return each week. She uses an example of a little boy that returns each week to the teacher, even if he has not done his homework, because she does not shame or have any expectations:
You know, think of ourselves as children, right? Eight years old and going to class, I didn’t do the assignment. But I still want to go to class. Because she loves me. You know and because I love being there.… she’ll help me and she’s not gonna shame me. Like how many of us have had that experience?
Hence, a secure attachment with a significant attachment figure, who does not shame or reject, offers the emotional safety for children and parents to learn with confidence.
Many parents are reluctant to bring their parenting problems into the public arena. Anna stated this is a “perception problem.” Furthermore, parents with avoidant attachment styles are more difficult to engage. Cara described a couple where the mother was motivated, the father had an avoidant attachment style but “both of them love [d] their kid.” The mother was “volatile with her child over nothing,” she admitted “I erupt… it’s really [over] nothing.” The father was “overly calm… little bit flat.” The father would “just sit there with his arms folded.” The clinician provided more space and time for the father to engage. As the sessions progressed, “When he started to open up, it got better for her [his partner] too.” Thus, the reluctance some parents have with trusting the facilitator and the group is overcome by addressing their needs.
Emotional awareness
Increasing emotional awareness, emotional regulation and attunement were recurring themes interwoven through the four interviews. According to Anna “emotion [is] a part of all those things” that are group processes, mindfulness training and attachment education. However, she reiterates, “emotion isn’t a change process. It’s the terrain of change processes… [you] can’t put emotion into the program.” This comment highlights a critical point, How do people transform? Contrary to Anna, the other clinicians inferred emotion is a change process, that increasing emotional awareness facilitates change. Cara stated parents are encouraged to gain more awareness of their emotions by asking questions such as “What are emotions? What is their relationship to emotions?” Bella showed the Perinatal Anxiety and Depression Australia (PANDA) video to raise awareness about postnatal depression. Diana encouraged parents to notice the intensity and energy of depression. Self-awareness of emotions aids in gaining mastery over differentiating between different emotions, such as fear, shame, curiosity, joy and delight. Bella highlighted the temporary nature of emotions with the comment “moods are like weather.” Becoming aware of the temporary nature of emotions and thoughts helped parents to be less reactive.
Mindfulness offers a phenomenological methodology for parents to explore their feelings, to understand their child’s feelings and to help their child be with overwhelming pain (Anna). It offers parents a phenomenological exploration to experiment with feelings. “...like MBSR, again respectful of people’s psychological defences,… putting them in the driver’s seat about how they unpack and unfold” (Anna). Both COS and MBSR are incredibly demanding of parents to look deep inside and be the best people they can be. Placing the parents in the driver’s seat to explore themselves is empowering. Similarly, Bella reported, “This is grist for the mill, this is all part of the process of experiential learning and knowing themselves a bit better, that sort of explorer. Being an explorer of their own subjective experiment.” Therefore, mindfulness as a phenomenological methodology enables the user to become an explorer of emotions, to not just be with the pain, but to process it and grow from it.
Attunement
Three of the four clinicians also highlighted the importance of attunement in focusing on the mind of another so both “feel felt” and “feel seen” (Anna; Cara). Both Anna and Cara emphasise, “feeling felt” facilitates the connection between the parent and child. Bella inferred attunement through use of terms such as “mirror neurons” and “reflective functioning.” All clinicians raised issues associated with parents who have experienced trauma. Traumatised parents appear to have difficulty tuning into their child’s feeling so that the child “feels felt” or connected. Anna states,
I find a lot of these parents who have had trauma don’t look at their kids in the face. Don’t actually see what is going on, so the kids feel unfelt. They feel not known, not inquired of… So I really invited him to start really catching her gaze whenever he could and just… That very important part of the COS program is delighting in the child.
Cara describes a mother’s epiphany, “Wow, so … I’m actually supposed to be tuning into them and filling their needs.” When the parents start recognising the child’s needs by looking at the child’s face, a didactic shift occurs where both the parent and child start reinforcing nurturing behaviour.
Affect regulation
Mindfulness offers tools to assist with affect regulation, affect differentiation, containment and inhibition. Common issues beguiling parents include difficulties with state regulation, such as sleeping, settling, mis-attunement and not responding appropriately or sensitively (Bella). Anna believes mindfulness provides more support to regulate emotions than COS. Cara makes a perceptive observation that “A child doesn’t have a strong enough nervous system to actually have self-control and they need the extended nervous system of the parent to help regulate their nervous system over and over and over again.” Thus, the parent is the extended nervous system for the child until the child can self-regulate.
“Emotional fireworks” as referred to by Cara are the volatile eruptions of rage. Anna refers to this rage as the “powerful limbic rage.” Both Cara and Anna highlight these volatile eruptions are easily triggered in parents with traumatic backgrounds. These symptoms resemble triggers for Post-Traumatic Stress Disorder. “It’s very hard to respond and be with the child [when you are] melting yourself” (Cara). Containment is the ability to inhibit habitual responses, the powerful limbic rage (Anna). The aim of inhibition is affect regulation, affect differentiation, to get to know your child and not to “blast them” (Anna). Parents gradually learn to contain their distress by learning to respond rather than react and recognising the shark music as their underlying fears.
When parents learn emotional regulation, it models this key skill to their children. Both Diana and Bella described a case study of a four-year-old boy with autism. The mother had attended the program for her second child. When the mother used to sneak off to do meditation practice, the little boy used to follow, sit and learn the three-minute breathing space. One day, the family had been shopping and running errands. When they returned to the car, they were all “overloaded” and “shaken.” Before the father started the car, the four-year-old boy makes the sound of a meditation bell and tells the parents, “Now I think we should all take a breathing space. … They actually all did the breathing space together, which was three minutes and she said it really calmed everyone down” (Diana). This example illustrates the ease with which intergenerational transference of positive emotional regulation can occur.
Social learning
Social learning was another higher-order theme that emerged from the interviews. All the clinicians highlighted the usefulness of social learning and positive peer pressure. Sharing struggles, triumphs and solutions appear to promote the gaining of insight and behaviour change. The mothers “suddenly don’t feel alone,” they “loved being in a group of other pregnant women” (Diana). All the clinicians were adamant this was “not group therapy,” it was an adult learning class. The distinguishing feature between group therapy and adult learning appears to be that participants were not encouraged to talk at length about their concerns. The aim of the class was to teach specific skills. It facilitated vicarious learning by providing a safe, warm, supportive environment (Bella). The sharing of experiences provided group validation, which transformed their thinking. The relationship with the teacher and the group was central to practicing new behaviour (Anna). The group dynamics appear to promote respectful inquiry in a secure space (Diana). The clinicians seem to skilfully nurture the “birth of the group” and the ongoing group dynamics to model emotional regulation. Group processes are also relevant outside mindful parenting groups. Culture is a social learning process that influences parenting even outside of a mindful parenting group. As such, culture is a subtheme within social learning. The group dynamics appear to be akin to the “extended nervous system,” a connection that supports parents to alleviate their distress.