I was recently a guest on a radio show about Postpartum Depression (PPD) in which the expert panelist was a very prominent leader in the field of PPD treatment. I was excited for the show and optimistic about the potential effects of having this discussion on this public forum. For a half hour I sat there listening to various iterations of the same treatment, pounded into the PPD treatment storyline: “date night” “an hour a day to yourself” “alone time” “independent interests”. I was sadly not surprised yet utterly disappointed that at no point in this entire discussion was Postpartum Depression or its potential treatment discussed in the context of the relationship out of which it is born! This is insane!
It is imperative that we bring to this conversation a voice of connection, a conceptualization of PPD as existing within a transition into a special relationship. While I am not going to argue against giving a new mom permission to soak in a solo hot bath, I am going to passionately suggest that we incorporate flourishing the bond between mother and baby into our modern ideas of PPD treatment (coincidentally, one of my favorite times of the day is my evening bath with my baby).
While the basis for PPD is multi-faceted (chemical, physical, emotional, psychological, intellectual, relational), it is defined within the relationship between mother and baby. I argue that while some might enjoy a date night, it is not only not the universal answer for every mom, but it neglects to address this central aspect of PPD. A focus on increasing disconnect across the board does not serve this relationship that is at the heart of the matter.
When a mother is struggling with PPD while caring for her baby, who is demanding everything she has to give and more just to stay alive, she can feel repelled when not directly engaging in the caretaking behaviors required for survival. This causes her to avoid behaviors like holding her baby, having skin-to-skin contact, breastfeeding on cue, babywearing, performing infant massage, giving kisses, engaging in conversation, and being consistently and attentively responsive. Ironically, these are the very behaviors that can foster the bond between mother and baby.
Engaging in attachment-promoting behaviors raises the levels of oxytocin in both Mom and Baby’s bodies. They call oxytocin the “love hormone” for a reason. It is a feel-good hormone that boosts your mood and makes you feel intensely positive feelings toward whomever you are engaging. Partaking in these behaviors helps mothers really get to know their babies. Knowing your baby well allows you to accurately interpret his cues and turns you into a more competent parent. When you are able to competently meet your baby’s needs, your baby’s trust is fostered. When a baby learns to trust in his parent, his need to cry is reduced and the amount of positive feedback you receive from your baby dramatically increases. When you are having successful interactions with a baby who is happy to receive you, you feel drawn to be close to your baby. Starting with one small attachment-promoting behavior, you can move step-by-step closer, spiraling into attachment with your baby, stepping into your new self as a mother, and out of the fog of PPD.
In addition to the effort of directly assisting mothers in establishing a healthy, rewarding relationship with their babies, the work of guiding mothers in authoring their new narrative is essential, written on the foundation of a strong connection. To grow into your bond with your baby, to allow yourself to be fundamentally touched by the attachment and to reach your parenting potential to guide this child, you must get to know yourself anew. This is not a passive quest but an active journey, one in which a postmodern (narrative oriented) pyschotherapist can act as your witness, posing questions that reframe your perspective and enlighten your path. But regardless of your chosen modality for finding your footing as the new you, this journey does not necessarily require separation within the mother-baby dyad. From the logistical detail of inviting Baby into the therapeutic space, to the broader conversations shifting from, “Try lots of new hobbies and figure out what you like to do on your own so you can remain a whole person (Don’t get lost in motherhood!)” to “In what ways are you now going to be fulfilled with the addition of your role as mother into your personhood (example: ‘What physical activities can you now incorporate into your life with your baby that will address your need for physical activity?’),” a fully integrated new you can leave you feeling grounded, stable, and ready to step into your new life as the mother to your baby. It is the work of living the answer to the question, “Who do you choose to be?”
This piece was originally written for a blog series about balance. The mainstream PPD approach today focuses on establishing balance outside of the mother-baby relationship. I urge our community to shift that focus to finding balance within it.