Postpartum Depression: Ambivalence as a Risk Factor
by Diana Lynn Barnes, PsyD., MFT
Ambivalence about the maternal role is one of the presenting psychological risk factors in the onset of a postpartum depression. As clinicians working with women and their families around issues of pregnancy and birth, it is of critical importance that we are able to identify risk factors that can potentially lead to a disruption in the developing attachment between mother and infant..
The birth of a baby acts as a catalyst for a new mother’s remembrances about herself as a child. She brings to this event a wealth of unrevealed and unconscious information regarding her relationship with her own mother. The profound emotional experience of pregnancy and birth gives life to the memories of her earliest experience along with sensations, feelings and stored impressions. An emotionally unsatisfying and difficult relationship with her own mother may leave a woman feeling isolated and believing that she lacks the necessary coping skills to nurture her newborn.
Mothers with postpartum depression tend to have significant doubts about their competency and efficacy. This is often a psychological outcome of ambivalence about their maternal role. Generally, this ambivalence stems from worries about their capacity to provide “good enough mothering.” They express grave concerns about their developing attachment relationship with their infants, and a profound fear that they may not have the emotional sustenance to be appropriately responsive, adequately attuned, and nurturing enough to meet the ongoing demands of their newborn. These kinds of feelings often leave new mothers vulnerable to a downward emotional spiral of hopelessness and despair with serious implications for the onset of a depression.
Because the birth of a child brings most mothers to a level of heightened sensitivity and responsiveness, unresolved issues between the new mother and her own mother play a significant role in the quality of the adjustment period postpartum. A mother’s all-encompassing feelings of love for her baby may be undermined by the presence of anxieties, ambivalence, and resentments that are connected with feelings and experiences she thought she had left to perish with the past.
By helping women, during pregnancy and after birth, to gain emotional access to some of the negative and confusing beliefs that influence their behavior, cognitions and feelings, we can lessen the potential risk for a postpartum depression. In doing so, we nurture the growing attachment between mother and infant, securing a more positive outcome for the psychological development of the child.
Presented at the Marce Society International Conference in England, September 2000.