I am happy to introduce you to Cassandra Vieten, Ph.D. to help us out with the integration of mindfulness into pregnancy, birth, and early parenting. Cassandra is a licensed clinical psychologist, director of research at the Institute of Noetic Sciences, co-director of the Mind Body Medicine Research Group at California Pacific Medical Center Research Institute in San Francisco, CA, and co-president of the Institute for Spirituality and Psychology. Her research has focused on mindfulness-based approaches to cultivating emotional balance, the involvement of emotion regulation in addiction and recovery, and the factors, experiences, and practices involved in psychospiritual transformation. She has published several academic articles and spoken at academic conferences worldwide.
She is also author of the wonderful book Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child’s First Year (New Harbinger/Noetic Books, 2009) and co-author of Living Deeply: The Art and Science of Transformation in Everyday Life (New Harbinger/Noetic Books, 2008).
Elisha: There is a whole field of psychology called “attachment theory” that is dedicated to understanding the effects of the child parent bond on the rest of our lives. What role do you see mindful parenting or mindful motherhood playing in this field?
Cassandra: This is a great question because Mindful Motherhood, or mindful parenting, does not happen in you as a parent. It happens in relationship with your baby, and it is increasingly being recognized how much of your child’s development is shaped by their early experiences with primary caregivers. My premise, and that of other scholars and clinicians such as Daniel Siegel, is that mindful awareness forms the ideal platform for healthy parent-infant attachment to take place.
From the Mindful Motherhood book:
For example, as a mom, having your attention in the present moment lays the groundwork for what developmental psychologist Daniel Stern called being attuned to your baby, or being aware of and perceiving accurately your baby’s communication of her emotions and needs. Attunement with your baby is sort of like a tuning fork–the baby hits a particular tone, and you resonate with that tone, reflecting it back to her with your facial expressions, tone of voice, touch, and way of being. These subtle actions communicate “Yes, I see and hear you, and I get what you’re feeling.” Through thousands of these little micro-interactions with your baby, her sense of self develops, as well as her own capacity to begin to learn how to deal with her emotions.
Attunement is not just matching your baby’s state. It’s making a complementary response, one that both conveys your empathy (“I can feel what you are feeling”) and responds appropriately to what the baby is communicating. For example, if the baby gets really upset, it’s not ideal attunement to get equally upset. Ideal attunement might be making sure the baby knows that you see that he’s upset and reflecting a sense of being able to tolerate or contain that upset. This reaction could be holding him with firmness and making low and deep sounds. Luckily, with present-moment mindful awareness that meets experiences as they are, this comes pretty naturally-you don’t have to figure it out with your thinking mind.
Transmitting a secure sense of self through attunement happens in thousands of micro-interactions, not just one, or two, or even fifty. This is not about being perfectly attuned all the time-that’s impossible. It’s about deciding that you want to actively engage, more and more often, in present-moment awareness with your baby and cultivating the capacity to do so. Your baby is always in the present moment. Mindful awareness allows you to join her there more often.
D. W. Winnicott was a pediatrician and psychoanalyst who is probably most famous for his work on “transitional objects.” These are the treasured objects, like a favorite teddy bear or blankie, that help toddlers transition from relying on mom for soothing and a sense of security, to being able to regulate themselves to a certain extent. Winnicott also talked about the holding environment, or the whole space around and between you and your baby, physically and psychologically, as you move through your days together. At first, you are pretty much solely responsible for creating and maintaining this holding environment. You maintain and regulate the connection between you and baby by staying present, aware, and in connection. By about three or four months old, your baby takes his turn being the leader in the dance. By this time he’s contributing quite a bit to the ongoing creation and maintenance of this environment. He’s eliciting facial expressions, emotions, and even thinking patterns in you. And if you’ve ever had your milk let down in response to your baby’s cry, you know he’s even driving some of your physiology.
But your job in this holding environment is to, well, hold what is happening. To tolerate his distressing moments, to recognize and reflect his feelings and their expressions in his body and on his face, even to be the target of and survive his anger, frustration, and aggression. You can do a kind of aikido with your baby. This is a martial art that emphasizes a reflective and complementary sparring, where you receive and reflect and give back some of what your partner throws at you, and some of it you just let pass right on through, protecting yourself by letting the force of your partner’s energy fly by. Mindful awareness can help you in this dance of attunement, synchrony, and consciously participating in co-creating the space through which both of you move through your days.
Elisha: Share with us a bit of the research you did that led to the book Mindful Motherhood.
Cassandra: A very robust scientific literature links postpartum depression to impairments in mother-infant bonding. In addition, a large body of empirical evidence in both animal and humans studies indicates that stress and mood disturbance experienced during pregnancy increases the risk for preterm birth (which is considered one of the most pressing problem in maternal-child health in the U.S.) and other pregnancy-related complications, and may adversely affect the developing fetus. Prenatal maternal stress may also be an important mediator of the observed relationship between race/ethnicity and rates of preterm birth.
In comparison to the potential far reaching benefits, relatively little research has focused on developing interventions to reduce stress and improve mood during the perinatal period.
In response to the need for a brief, low-cost, non-pharmaceutical intervention to reduce stress, improve mood, and decrease the effects of stress and distressed mood on mother-infant bonding, and based on our own experiences as parents, my colleague John Astin and I developed the Mindful Motherhood program. Bringing together elements from several different mindfulness-training programs, as well as our own newly developed material, we piloted the program first in a group of ten women.
After this group ended, we made some changes to the program based on participants’ feedback and our experience as facilitators and researchers and tried it out on another group of women. Finally, we compared two groups of women–one that received the training in pregnancy and one that did not. The women who did not receive the training during pregnancy participated in it when their babies were between three and six months old.
Though small, this pilot study showed that it was possible to learn mindful awareness during pregnancy and early motherhood (even with baby in tow!), and women who engaged in mindfulness training during pregnancy had reduced negative emotions and anxiety during pregnancy compared with women who did not participate in the training (Vieten and Astin 2008). There were also trends toward reduced symptoms of depression and increased positive emotion.
Thank you so much, Cassandra, for your wisdom.
To my readers: Please share your thougths, stories, and questions below. Your interaction provides a living wisdom for us all to benefit from.