Included here are notes on:
- Just Being There
- The Impact of Colic
- Myths About Motherhood
- Perinatal Mood Disorder
- For Volunteers
- Attachment
Just Being There
Acting As A Guardian
One of the greatest gifts we can give another human being is to act as their guardian, to hold space for them.
One of the greatest gifts we can give another human being is to act as their guardian. Whether this gift is related to a specific situation or is representative of an ongoing commitment, we each benefit from the association. To protect someone is to walk with them in challenging times and see them through safely to the other side. In doing this, we grow with them. And those under our guardianship derive confidence from our support and assistance, enabling them to persevere through almost any conditions.
There are many reasons we feel inspired to serve as guardians to those we care for. Sometimes just holding the space for somebody allows them to do what is necessary to grow or heal. We may simply want to see that our friend or loved one is taken care of and equipped to prevail over difficult circumstances. We may also sense that we are in possession of knowledge our loved ones are lacking yet need in their current stage of development. Our offer to serve as a guardian may also be both unsolicited and unrelated to any one situation. Instead of helping someone we care about cope with a specific challenge, we may find ourselves providing them with a more general form of emotional sustenance that prepares and strengthens them for challenges yet to come.
Our ability to empathize with those under our guardianship is our greatest asset because our comprehension of their needs allows us to determine how we can best serve them. Even when this comprehension is limited, however, the loving intentions with which we enter into our role as guardian ensure that our care and protection help others grow as individuals while living their lives with grace.
From The Daily Om: http://www.dailyom.com/
The Impact of Colic
Please don’t underestimate the effects of colic. Not being able to console an infant can touch the deepest helplessness in a parent. Rationally we can know the discomfort in the infant will stop in a few months. However, the parents’ feelings aren’t always rational and “a few months” means “my baby will cry forever and I will NEVER be able to comfort her.” The mother may be able to balance her checkbook to the penny, be a skilled and responsible employer or employee, be confident in intimidating situations and now she has been brought to her knees by eight pounds of crying baby.
Some myths:
In our culture there are many myths about motherhood and babies:
Motherhood is instinctual
Mothers love their babies at first sight
This is the most wonderful time in a woman’s life
Now you have a baby you are totally fulfilled
Your relationship won’t change
Babies sleep
For the mother some, or none,of these may be true. As volunteers it is important not to impose these commonly held ideas on the new mother. Most mothers want to be the best mother. They put a lot of pressure on themselves. The new mother may question her competency. Is she doing this right, is she good enough as a mother; does her baby like her? How she knew herself is not how she is experiencing herself now. Hormonal shifts and lack of sleep can also contribute to feelings of vulnerability. Birth is considered a developmental crisis. Babies have become an industry and the need to be a great parent gets marketed to. This is a reality. Surely, a different nipple on the bottle, a different diaper on the bottom or a change in formula will soothe a fussy baby. Companies know this. The media knows this. But one of the greatest gifts a volunteer can bring to a family is the assurance that everything they need to know is right inside them! Sometimes a parent may need some assistance finding this “knowing” and we can be there to facilitate that process. Feelings are like a roller coaster and all need to be taken seriously.
Postpartum Depression (Perinatal Mood Disorder)
Postpartum depression, often referred to as the more inclusive Perinatal Mood Disorder, affects many women. Kate Dow Ph.D., LPCC has a private practice in Santa Fe, N.M. specializing in PMD and new parent transitions. She runs support groups for women with PMD and groups for spouses/family of mothers suffering from PMD. The following information from Kate has been helpful to parents and to volunteers.
All new mothers experience a wide range of feelings before and after the birth of their babies i.e. sadness, anger, guilt or worry. However 3 out of 10 women will have feelings that include panic, excessive fears about self or baby, overwhelming loss, sleep disturbances and episodes of feeling out of control. These are symptoms of a Perinatal Mood Disorder (PMD). Extreme cases of PMD include psychosis with bizarre feelings and delusions, only occur in one in one thousand women.
The risk factors for PMD include a variety of biological, hormonal, interpersonal and intrapersonal factors. There is no clear recipe. What we know for sure is that it is not a woman’s fault. It’s a NO-Fault illness! Women are not to blame. It is not a weakness. PMD is a condition.
Another important fact is that every affected mother will experience PMD differently. For some it is a feeling of tremendous sadness, confusion and guilt and has difficulty sleeping . Another will experience anger, anxiety and suicidal flashes and obsessions.
The one common expression of women with PMD is, “I don’t feel like myself.” PMD also, uniquely, has a come and go effect with good and bad days making it confusing to clarify what is going on.
Seeking help is essential for recovery. A woman cannot will herself well. Treatment varies depending on the severity and duration of symptoms. All symptoms are TREATABLE. Treatment may include a medical exam, counseling, support groups and psychiatric evaluation. With help women can and will recover themselves from PMD.
For Volunteers:
Being with new mothers as a volunteer puts you in the unique position to be with mothers in their home and natural environment. You get to see more of the new mom’s feelings and behavior than most people do. However, keep in mind mothers with a Perinatal Mood Disorder may not know it or want you to see their struggles and hide it very well.
Perinatal Mood Disorders look different for different women. Women can appear depressed with low energy, sad, crying and confused. One mom may look anxious, easily overwhelmed when the baby cries and not eating or sleeping well, while another mom may obsess about the baby’s health, safety and wellbeing. Another mom may be very moody and easily angered, feeling inadequate as a mother and maybe experiencing a PMD. When a mom looks like she is having a lack of feelings for her baby, this may be a PMD.
Once you have created a rapport with a new mother some great questions can be”
"How are you feeling about motherhood?"
"Are you getting enough physical and emotional support?"
“Are you generally feeling like yourself?”
“How is breastfeeding going?” or “How did weaning go?” if formula feeding
“What part of being a new mom is the most difficult?”
Early detection is the most crucial piece for recovery for a mother with PMD. The negative rippling effects on bonding, health, marriages are tremendous. If you have any feelings that things are not quite right when you are visiting a family do not keep it to yourself. If you have concerns about a new mother you need to speak to the Volunteer Coordinator who had the first contact with this mother as soon as possible. The Coordinator can then speak to the mother and her family about meeting with her doctor AND getting an assessment with a professional for PMD.
In Santa Fe Many Mothers has been fortunate to have Kate Dow and several doctors who are familiar with the signs for Perinatal Mood Disorders. It is never up to the volunteer or staff to provide a diagnosis for a mother. It is our responsibility to be informed, to know what the resources are in our community and to provide support to the family.
For online support, information and listing of local assistance visit:
Postpartum Support http://postpartum.net
Depression after Delivery http://www.depressionafterdelivery.com
The Step by Step guide which accompanies the Many Mothers manual came from Jane’s intimate experiences with and understanding of postpartum depression. A she says, “No woman should have to call long distance for support ~ it must be close at hand to provide the immediate comfort, guidance and encouragement that mothers suffering from postpartum depression (PPD) need so badly.”
Janie Chodosh, a new mother to gorgeous Isabella, shares the following:
The first month of my daughter’s life, I experienced a range of emotions familiar to any new parent: fatigue, delirium, joy, fear. My days passed in flannel pajamas and slippers sitting in an armchair by a sunny window nursing my baby, rocking her in my arms, and going on walks when I could muster the energy. A sleepless daze settled in as I adjusted to my new role as a mother. Had I seen post partum depression coming, I might have lined up my arsenal of depression fighting techniques and prepared for battle. But the onset of the illness was subtle, and before I knew what was happening, my life was turned upside down.
The birth of my baby didn’t go as I’d hoped. I’d envisioned a drug free, natural birth. Instead, I had a twenty plus hour labor followed by an emergency cesarean and a four-day stay in the hospital. My first weekend home from confinement of the hospital walls, I wept for two days. Com Monday morning my husband would be returning to work and I’d be alone with a week old baby. How had I fooled the doctors, nurses, my parents and husband, and made them believe at 35 I knew how to take care of this tiny new being? I plodded around the house with weepy red eyes, barely able to form a sentence without tears pouring down my face. Two days of crying and I started to feel better. Thank god, I thought. Having struggled most of my life with a low level form of depression, I figured I was a perfect candidate for post partum depression. This illness had been mentioned in my birth education class along the lines of:”If you feel bad for more than two weeks after the birth of your child, you probably have postpartum depression and should seek help.” What did “if you feel bad,”mean? Did exhausted and stressed out constitute feeling bad, or was something more serious implied?
The week before Thanksgiving, five weeks after my daughter’s birth, I started having trouble falling asleep. After nursing my baby, I’d toss and turn, unable to drift back and catch those few hours of precious sleep before the next feeding. Nights passed and the periods of not sleeping grew from half an hour, to two to three hours. As my sleep grew worse, the baby’s grew better. She stopped waking for the 11:00 feeding and soon was waking just once during the night. When I called my doctor and complained about my sleep problem, she told me to drink warm milk and honey.
Had sleep been my only problem, warm milk and honey might have been enough to relax my body and coax my sleep patterns back to normal. My mother suggested reading at night. Someone else suggested hot baths. I was told to try lavender oil, herbal tea, relaxation tapes. Nothing worked and now as I lay in the dark watching the clock, I started experiencing hot flashes, shaking hands, and surges of adrenalin as if I were about to plunge down a steep drop on a roller coaster. Four in the morning, my husband, baby and two dogs sleeping, I’d have thoughts of getting in my car and driving off the road, or swallowing handfuls of painkillers.
During the day I didn’t want to be alone. The thought of caring for my baby by myself began to feel like an impossible task. I wanted my mother. I wanted to be taken care of and told what to do. Where was this coming from? Who was this person with suicidal thoughts and fear of being alone? Since I was ten and refused to wear dresses, I’d always been independent and now I didn’t want to be on my own for even a few minutes. The feelings of hopelessness, shame and emptiness settled in my gut and I wanted nothing more than to lie down for a long sleep.
My baby was the one thing that kept me grounded. She needed me and I needed her. I didn’t want to waste this precious first year of her life unable to feel joy. I knew I had to fight.
I went to see my doctor and she prescribed an anti-depressant to help with my moods and a sedative to help with sleep. I started sleeping again and we got the baby on a bottle so my husband could take the nighttime feeding. Having a supportive husband, willing to wake and be with the baby and still go to work in the morning, was, and continues to be, a blessing.
I took a few months for the full effect of the antidepressant to settle in and the fog to lift. I went back to counseling, started getting out in the day-visiting with other new moms, exercising whenever possible, doing some part time work and rebuilding and understanding my new life and identity.
I look back on those days, not so long ago, and am thankful I sought help and was proactive in my healing. I am thankful for doctors and therapists who recognize and know how to treat post partum depression, for parents and a very dear friend who offer constant support, for the love of my husband, and most of all, for the bountiful joy of my life, my baby girl, Isabella.
Attachment – The heart of the program
One of the reasons we enjoy providing service to families with infants is being able to help a family get off to a good start. Experience has shown us the more the needs of the parents are met, the more time and energy they have to focus on their newborn and other children. It is common sense. We don’t think of it very often but when we remember what it feels like to have our own needs met we can feel how much more relaxed we are. Life seems easier and the world is a friendlier place. It helps us understand better how the bonding between a parent and infant can be enhanced by this kind of volunteer support.
When our program had been providing service for several years, sometimes parents would talk with the volunteer about “attachment parenting.” The mother would talk about breast feeding for a year or more, she would wear the baby in a sling keeping the baby close to her body, and the parents and baby shared the family bed. Initially, some of us who had “successfully” raised bottle fed babies who slept in their own rooms and had been encouraged to let our babies cry out their frustrations were skeptical about one more theory of child rearing. However, even the most skeptical among us had to admit, whatever our reservations were, we were seeing the most heart-connected parenting. In a very fast paced, technology-filled world, these parents had slowed down and were really being with their babies. The babies were thriving!
In our volunteer meetings, we began to talk about some issues that were surfacing for us. We admitted it had been easier to have rules to follow; to parent as our parents had. Some volunteers had wanted to parent their children differently and had taken Parent Effectiveness training. They talked about the commitment it took to learn new skills. Some volunteers said they had not had the confidence to trust themselves; to know they could learn from their babies. We talked about how “another theory’ could feel threatening to some of us. How? Well, if we hadn’t raised our babies this way did it mean we hadn’t done a good job? Or if we didn’t “know more” than the new parents, did it mean we weren’t useful to the parents? These were courageous conversations we were having where we were honest enough with ourselves and with each other to talk about our fears and our beliefs. It reminded us all to be open to learning. Both the parents and the infants are our teachers.
The great irony was whether we agreed with these ideas or not, every one of us agreed this is NOT just another theory! These ways of parenting have been practiced through the ages all over the world. Today there is scientific data supporting attachment theory. Brain and social development are positively impacted by attachment parenting.
While Many Mothers strives to support parents and their style of parenting, we also understand sometimes we are in a unique position to share information with new parents. Having the tools to do this is crucial. “The Attachment Parenting Book: A Common Sense Guide to Understanding and Nurturing Your Baby” by Dr. William Sears and Martha Sears, R.N. has been a helpful resource for parents and volunteers. Also included is an article by Deborah Harris, LISW. At the end of the article, Ms. Harris has included some excellent resources. Attachment IS the heart of this kind of service.
A Synopsis of Attachment
Compiled by Deborah Harris, LISW
“…. love of an infant is of a different order. It is twinned love, all absorbing, a blur of boundaries and messages. It is uncomfortably close to self-erasure, and in the face of it one’s fat ambitions, desperations, private icons, and urges fall away into a dreamlike before that haunts and forces itself into the present with tough persistence.”[1]
Attachment has been described as the first love that humans experience, the one that sets the stage and forms a template for all relationships to come: the love between an infant and a parent. There have been a number of descriptions and phrases used to describe what transpires between a newborn infant and her parents in the attachment process.[2] All derive from the basic fact that young children are entirely dependent on the care they receive from others. In this sense there is no such thing as a baby as a sole and separate entity. A baby must always be in the care of someone. All of a child’s physical and psychological needs must be met by one or more people who understand what infants in general need and what this baby in particular wants. The child’s growth, in all aspects of health and personhood, depends on the capacity of the adults in whose care the child rests to understand, perceive and respond to the child’s bids for assistance and support.[3]
John Bowlby uses the term “attachment” to describe the affective bond that develops between an infant and a primary caregiver: “Attachment is the enduring emotional relationship between the parent or caregiver and the infant that brings safety, comfort, security and pleasure.”[4] In this view, attachment is a pattern of interaction that develops over time as the infant and caregiver interact, particularly in the context of the infant’s needs and bids for attention and comfort. Bowlby describes the infant as biologically predisposed to use the caregiver as a haven of safety or a secure base while exploring the environment; when the infant feels threatened she will turn to the caregiver for protection and comfort. The caregiver’s response to such bids helps mold the attachment relationship into a pattern of interaction over the first year of life. This developing relationship between infant and caregiver allows the infant to begin to anticipate the caregiver’s response to bids for comfort.
Stroufe describes the attachment relationship in terms of the “dyadic regulation of the infant’s emotions and arousal.”[5] Since young infants are not capable of regulating their fluctuating emotions they require the assistance of a primary caregiver to modulate them. The young infant is equipped to express distress through crying and other signals. Responding to these signals keeps the infant’s distress and arousal within reasonable limits and represents the beginning stages of coordination in the emotional regulation process. In the first few months of the infant’s life the caregiver is solely responsible for regulating the infant’s emotions. To be well regulated requires a sensitive and responsive caregiver—one who is adept at interpreting the meaning of the infant’s behavior and who responds in an appropriate fashion.
As infants get older and become better at expressing their needs and intentions, caregiver regulation evolves into mutual regulation (Tronick 1989) [6], or, as Stearn (1985)[7] calls it, “attunement.” By the second half of their first year, infants behave in ways that elicit particular caregiver responses. A coordinated pattern of interaction, subsumed within the framework of Bowlby’s attachment theory, carries forward and forms the basis for the development of self-regulation. According to this view, the attachment relationship is central to the regulation of emotion and arousal.
One of Bowlby’s major conclusions following his initial groundbreaking work was that to grow up with optimal mental health, “the infant and young child should experience a warm, intimate and continuous relationship with his mother (or mother substitute) in which both find satisfaction and enjoyment.”[8]
Bowlby also saw the caregiver-child relationship in a social and economic context, and argued, “Just as children are absolutely dependent on their parents for sustenance, so…are parents, especially their mothers, dependent on a greater society for economic provision. If a community babies its children, it must cherish their parents.”[9]
All this research confirms that biological systems predispose human beings to form and sustain enduring, nurturing relationships. Sensitive and responsive caregiving is a requirement for the healthy neurophysiological, physical and psychological development of a child.Sensitivity and responsiveness are the key features of caregiving behavior related to later positive health and development outcomes in young children. Sensitivity can be defined as an awareness of the infant and of the infant’s acts and vocalizations as communicative signals that indicate needs and wants, while responsiveness is the capacity of caregivers to respond contingently and appropriately to these signals.
Loving care provides the infant with a mirror reflecting tender and sympathetic view of self and the world. Early experiences function as schema on which the infant then predicts future events and encounters. The young child who receives loving care feels that he is a loved person and expects other people to respond to him as someone deserving of care and attention. In contrast, a child whose needs have been neglected does not usually expect others to be kind and considerate, and frequently behaves aggressively and defensively.
The presence or absence of a nurturing environment during childhood not only shapes a child’s psychological and emotional development but also alters brain development in ways that profoundly affect long-term health. Inadequate, disrupted and negligent care has adverse consequences for the child’s survival, health and development. The quality of caregiving relationships has an impact on children’s health and development as well as their psychological well-being. These effects occur because children whose care is less than adequate or whose care is disrupted in some way may not receive sufficient nutrition, which may affect their physical development; they also may be subjected to stress, physical abuse and neglect, and since caregivers may not detect early signs of illness, they may not receive proper medical attention when ill.
Infants and caregivers are prepared, by evolutionary adaptation, to have caring interactions through which the child’s potential human capacities are realized. The newborn is “wired” to interact and engage with, as well as depend on, nurturing human care. From the first moments of life, newborns prefer and attend to the face, gestures, and voices of other humans. Their capacity to express simple emotions through facial expressions and movements guides caregivers to understand and respond in ways that are most helpful.
Factors directly affecting the caregiver and child, including underlying social and economic issues, influence the quality of caregiver-child relationships. Barriers to the natural emergence of a caring relationship disrupt the care an infant’s needs. Caregiver mood and emotional state are critical determinants of caregiver behavior, for example, with consequences for the child’s health and development. Studies of maternal depression illustrate how self-preoccupation and a negative mood can disrupt caregiving. Faced with chronic stress or anxiety, the caregiver may withdraw from her infant and become inattentive to the child’s physical and psychological states. Chronic stress, associated with poverty and other environmental challenges, can also disrupt the capacity of adults to give loving care. On the other hand, a strong caring relationship can protect a child from the effects of deprivation and disadvantage.[10]
In summary, the first years of life are the most important for the growing infant’s development in all critical domains: self-regulation, cognitive development, language acquisition, and social-emotional adjustment. These essential developmental acquisitions can only occur in the context of a relationship between infant and caregiver wherein positive and nurturing interactions between infant and caregiver foster optimal brain development and healthy attachment patterns. The presence of a secure attachment between parent/caregiver and infant provides a protective factor, which in longitudinal studies of security of attachment has been shown to increase resiliency and decrease the severity of the impact of major stressors. To recall Bowlby’s astute observation, in order to raise healthy children, we must also attend to the needs of their parents. As a family, community or nation, we must make healthy attachment relationships in infancy a priority.
References and Resources
Bowlby, J. (1980). Attachment and Loss: Vol. 3. Loss. New York: Basic Books.
Bowlby, J. (1982). Attachment and Loss: Vol. 1. Attachment. New York: Basic Books.
Byron Egeland and Martha F. Erickson, 1999. “Attachment theory and research.” Zero To Three, Volume 20, No. 2.
McBride, S.L., Brotherson, M.J., Janning, H. & Demmitt, A., 1993. Implementation of family-centered services: Perceptions of families and professionals. Journal of Early Intervention, 17(4), 414-430.
Parlakian, R. & Seible, N., 2002. Building strong foundations; practical guidance for promoting the social-emotional development of infants and toddlers. ZERO TO THREE Center for Program Excellence. Washington D.C.
Parlakian, R., 2001. The Power of Questions: Building quality relationships with families. The ZERO TO THREE Center for Program Excellence. Washington D.C.
Stern, C., 1985. The interpersonal world of the infant. New York: Basic Books.
Strouf, L.A., 1996. Emotional development: The organization of emotional life in the early years. New York: Cambridge University Press.
Tronick, E.Z., 1989. Emotions and emotional communication in infants. American Psychologist, 44 (2), 112-119.
Waters, Rob.“The Baby Brain Connection.” San Francisco Chronicle Magazine, November 14, 2004, p. 16.
World Health Organization, Department of Child and Adolescent Health and Development, 2004. “The importance of caregiver-child interactions for the survival and healthy development of young children: a Review.”
YMCA of the USA, Dartmouth Medical School, Institute for American Values, 2003. “Hardwired to Connect The New Scientific Case for Authoritative Communities.”
Zero To Three National Center @ zerotothree.org. They have a wonderful journal, webpage full of resources and publications.
Zero To Three, 2001. “Learning and Growing Together with Families: Seven Ways To Build Strong Relationships.”
Video Tapes
Seeing is Believing: Videotaping families and using guided self-observation to build on parenting strengths. Irving B. Harris Center, University of Minnesota, 1999.
The First Years Last Forever by the I am your child Foundation with Rob Reiner.
Right from the Start – this is a good overview of attachment theory, research and application.
Shaping Youngest Minds, The Learning Seed. This is a good summary of infant brain development and risk and resiliency factors.
[1] Erdrich, Louise, The Blue Jay’s Dance, 1995. HarperCollins Publishers.
[2] (Note: the use of “her” refers to either a male or female child, while “parents” includes primary caretakers, not necessarily biological parents).
[3] World Health Organization, Department of Child and Adolescent Health and Development, 2004. “The importance of caregiver-child interactions for the survival and healthy development of young children: a Review.”
[4] Bowlby, John, 1969, 1982 Bowlby, J. (1980). Attachment and Loss: Vol. 3. Loss. New York: Basic Books.
Bowlby, J. (1982). Attachment and Loss: Vol. 1. Attachment. New York: Basic Books.
[5] Stroufe, L.A., 1996. Emotional development: The organization of emotional life in the early years. New York: Cambridge University Press.
[6] Tronick, E.Z., 1989. Emotions and emotional communication in infants. American Psychologist, 44 (2), 112-119
[7] Stern, C., 1985. The interpersonal world of the infant. New York: Basic Books.
[8] WHO, 2004
[9] WHO, 2004
[10]WHO, 2004