Ways to Nurture the Mother-Child Relationship in the First Year
Deborah Groening-Rother, PsyD
First time motherhood is a profound period of transformation in a woman’s life cycle. It effects the very core of her identity – her relationship with her partner, her friends and family, and her day-to day structure and rhythm, all contributing to changes in her core sense of self and well-being. So many things are happening all at once. So many changes. So many things to learn.
Our culture expects new mothers to be naturally thrilled at the arrival of the new baby, but this is not always the case. When the mother isn’t happy for whatever reason, her ‘secret’ haunts her and of course impacts the infant’s well-being. There are a number of psychological states that can interfere with healthy bonding during the birth to early infancy stage through no fault of the mother. Mom and baby are just getting to know one another. There is no such thing as maternal instinct. This long held belief may stop a woman from seeking help if she is feeling resultant shame or fear. There are just so many variables that can have an impact on this important developmental stage: mother might be struggling with anxiety, depression, a physical illness, feelings of isolation, financial or career stressors, substance abuse or addiction, while the baby may have health or developmental delays on top of all that.
Another issue not often considered is the notion of “goodness of fit”. Again, not something one can anticipate in advance but, if the mother is very outgoing, and the baby is very tentative and shy, or the reverse, if the mother’s mood is more depressed while the baby is imploring the mother to play and engage, this can hamper things going as they should as well. There might be challenges related to breastfeeding, body dysmorphia, or to the mother’s fantasy expectations of meeting a certain kind of baby and, if the reality doesn’t match up, this can cause maternal disappointment and infant distress. Infants rely on their mother’s capacities to calm and contain their unregulated affect. The baby may have developmental delays that mom hadn’t previously considered and was therefore caught off guard. And then there may be unforeseen circumstances that simply come with being a human being. The mother may be grieving the loss of a parent or other loved one just as she is expected to welcome this beautiful new life. Although so many things can happen that have nothing to do with the mother’s good intentions, she may feel like a failure or a bad mother, or that she has been given the “wrong” baby and that there is no hope.
Mother-baby or dyadic therapy aims to provide a safe place to explore whatever is happening, always with the therapist sensitively providing support in an empathetic, non-judgmental way. With help, most maternal issues resolve themselves in a relatively short period of time but until then, given the vulnerable state of the dyad, mama-baby troubles will require an infant mental health interventionist to process the loss and allow for a grieving period. Counseling can help in the interim, providing a holding environment for the new mother/infant couple to observe, explore, and grow at their own pace.
In an ideal world, the mother would have individual weekly treatment in addition to once weekly dyadic sessions. This way she can have the space and time to talk about other issues impacting her life outside of her new mother role. She may be dealing with challenging issues related to her partner, career, in-laws, or parents where old unresolved wounds from her childhood may need some attention even if they were considered old news and irrelevant. We would become curious about what is being generated from the mother’s mind, from the infants, and what unconscious elements might be from past generations that are not yet understood or fully metabolized, coming back after being dormant for many years. Even when a mother is instantly in love with her baby, feels great, and has all the support she needs, she might feel anxious or overwhelmed by the enormity of the task of raising her child in these troubling times. As pediatrician and psychoanalyst D.W. Winnicott says, “there is no such thing as a baby; there is only a baby and a mother.” Conversely, I suppose there is no such thing as a mother, there is only a mother and a baby.