Using maternal representational patterns to evaluate postpartum depression.
This paper has reviewed postpartum depression through the use of a case history. As exemplified by the case, a key factor contributing to the onset of postpartum depression appears to be the caregiver's representations of her own experience with caregivers. In general, mothers whose representations of their childhood experience are positive appear psychologically equipped to transfer these emotions to the infant and to assume caregiving tasks with enthusiasm. In contrast, mothers whose representations of their caregiving experience are negative are apathetic about engaging the infant in interaction and hesitant about accepting the maternal role. While several etiologic factors have been linked to postpartum depression, representational deficits may provide a more comprehensive explanation of the origins of the disorder because such deficits encompass not only the mother's capacities, but also influence the interactional patterns mother exhibits with the infant. The case history describes a mother who represented a conflicted relationship with her own caregiver. Initially, her representations of her own mother were vague and unclear. Through inquiry, however, she gained access to her own experience--or, at least, to her representation of it--and began to understand how her own memories had negatively affected her ability to interact adaptively with her infant son. Treatment focused on three areas: Overcoming the mother's depressed affect; providing behavioral support for the infant's developmental efforts; and, re-invigorating the dyadic relationship. To accomplish these goals, the mother was taught observation techniques and intuitive behaviors. These techniques enabled her to view the infant in an objective fashion, devoid of distorted representations from her own childhood that reflected her attitude toward her caregiver. Helping the mother attain this new perspective enabled her to generate more adaptive representations, to acknowledge infant development more positively, and to initiate an adaptive dyadic exchange.
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Child and Adolescent Outpatient Department, New York Hospital-Cornell University Medical Center, White Plains 10605, USA.
D000328:Adult; D003142:Communication; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008425:Maternal Behavior / Q000523:psychology; D008568:Memory; D008960:Models, Psychological; D009034:Mother-Child Relations; D009769:Object Attachment; D011644:Puerperal Disorders / Q000523:psychology*