In our book A Womb of Her Own (Routledge, 2017) author Kristin Reale writes as follows: There are lot of discussions, papers, and supervision around the pregnant therapist, the unseen baby in the room, the altered relationship between patient and therapist due to the added fantasized member in the mix. But what about after the baby arrives and the months and couple years after? How does motherhood change the psychotherapist and her feelings of being a therapist? What is she experiencing behind the curtain? How has her own tangible experience of motherhood transformed her ideas of what it means to mother, and be a mother and to hold? As I address these questions I hope to further our thoughts about the medical and psychological epidemic that is post-partum depression. I will explore these issues using my own postpartum experience in conjunction with a long term clinical case of mine, including Winnicott’s reflections in his seminal paper Hate in the Countertransference. (Winnicott, 1958) In so doing, I want to challenge the ideas of the idealized mother, and in turn, the idealized image of good therapist.
Review of the Literature
Before relating my own experience I want to briefly explore the relevant literature. Firstly, there has been a vast amount of psychiatric/medical research on postpartum depression focusing on the biological/hormonal factors for women. However, surprisingly, it has come to my knowledge through my own research that there has been astonishingly little published psychoanalytically about postpartum depression and the root causes. Furthermore, I have found nothing published on the intersection between the development of PTSD and postpartum depression after a woman experiences a difficult and traumatic birth experience. After hearing countless harrowing birth stories personally and professionally, I find this just as surprising. If upwards of one in four women experience postpartum depression, how can it be that a miniscule amount of literature exists investigating the psychoanalytic underpinnings of postpartum depression? As a woman and as a clinician, I find this very concerning. I can only imagine the neglect of the subject matter is due to an unconscious patriarchal need to repress the sometimes dark experience of the new mother in order to preserve the historically idealized mother for deep seated cultural and psychodynamic reasons.
The Idealized Mother: Entrenched in Our Culture
We know that the image of the idealized mother has an entrenched colluded role in our shared historical reality (Winnicott, 1958; Dally, 1983), and this idealization unfortunately has not served women well with regard to their adaptation and emotional needs postpartum. As reviewed by Nadelson (1984), Dally (1983) has written an excellent piece on the established historical forces regarding the creation of the idealized mother. Dally focuses on a very important turning point in the conception of the mother — the post-World War II shift — which she attributes to “the impact of John Bowlby’s work on attachment and bonding”. (1983) She states that Bowlby’s work resulted in an idealization or over-idealization of motherhood and influenced a movement toward the intense sole dyadic relationship of mother and baby. Nadelson (1984) notes that Dally “emphasizes that for the first time in history the majority of women began to raise their children without the active participation of fathers, family, or community”. (Dally, 1983) Dally “decries the result, suggesting that this confined women to their homes, fostered guilt and blame, and has not produced a generation of psychologically healthy people”. (1983) Furthermore, she “suggests that the importance of other people in the lives of children has largely been overlooked.” Following Dally’s premise based on her historical research of the idealized mother, it seems that she is one that is isolated and pressured to be perfect: two major factors in the risk of postpartum depression. (Blum, 2007)
Blum, Lawrence D. Psychodynamics of postpartum depression. Psychoanalytic Psychology, Vol 24(1), Jan 2007, 45-62.
Dally, Ann. Inventing Motherhood: The Consequences of an Ideal. New York: Shocken Books, 1982
D.W. Winnicott : ‘Hate in the countertransference’ in Collected Papers: through Paediatrics to Psychoanalysis (London 1958).
Nadelson, Carol C., Review of Inventing motherhood, the consequences of an ideal. Family Systems Medicine, Vol 2(1), 1984, 98- 100.