Table Of ContentDropping the Baby
and Other Scary Thoughts
2
Dropping the Baby and Other Scary Thoughts
Breaking the Cycle of Unwanted Thoughts in Motherhood
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Karen Kleiman and Amy Wenzel
New York London
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Routledge
Taylor & Francis Group
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New York, NY 10016
Routledge
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© 2011 by Taylor and Francis Group, LLC
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International Standard Book Number: 978-0-415-87700-8 (Hardback)
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Library of Congress Cataloging-in-Publication Data
Kleiman, Karen R.
Dropping the baby and other scary thoughts : breaking the cycle of unwanted thoughts in motherhood /
by Karen Kleiman, Amy Wenzel.
p. cm.
5
Includes bibliographical references and index.
ISBN 978-0-415-87700-8 (hardback : alk. paper)
1. Postpartum depression. 2. Motherhood--Psychological aspects. 3. Childbirth--Psychological aspects.
4. Mothers--Mental health. I. Wenzel, Amy. II. Title.
RG850.K54 2010
618.7’6--dc22
2010026696
ISBN 0-203-83561-1 Master e-book ISBN
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the Routledge Web site at
http://www.routledgementalhealth.com
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This book is dedicated to Ilyene Barsky, MSW, whose words, wisdom, and infinite presence continue to inspire and
heal postpartum women.
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Preface
You’ve just had a baby, and you’re having thoughts that are scaring you. Thoughts that don’t make sense.
Thoughts about bad things happening to your baby by accident, by illness, or by your own actions. Maybe
your thoughts are about harm coming to your partner or yourself. You wonder, Why would I be thinking these
things? Maybe I shouldn’t have had this baby. Maybe something is wrong with my mind. Could I be going crazy?
Your impulse is to run, to hide, and to deny that these thoughts are even there.
Motherhood and scary thoughts. To most, this is an oxymoron, a contradiction in terms. After all, if
motherhood embodies the bliss that so many envision, how do we make sense out of the egregious thoughts
that often present themselves during this time?
If you’re reading this book because you or someone you love is struggling with distressing thoughts after
having a baby, it is our hope that you will find comfort, explanations, and coping strategies to understand and
manage this phenomenon better. Some of you may have been diagnosed with postpartum anxiety or
depression; others may be wondering if one of these diagnoses might apply to them. The information in this
book will be helpful whether or not you have been formally diagnosed with a postpartum anxiety or mood
disorder. After all, having a baby and having scary thoughts are a disturbing combination, whether or not
there is an associated diagnosis.
When we envisioned this book, we initially felt intimidated by three sets of challenges. The first was the
taboo surrounding this phenomenon. Could we effectively and compassionately tackle a subject that is so
taboo and so shocking—to consumers and healthcare professionals alike—that both groups frequently avoid
addressing it altogether? Could our efforts cut through this resistance and misinformation in a meaningful
way, while getting to the core of the pain? And would our efforts lead to more effective identification,
referrals, and treatment when indicated, and, most importantly, greater understanding and comfort for the
suffering mother? This was our clinical challenge.
Our second set of challenges rested with our audiences. In our clinical practices, we recognized a scarcity of
accurate information on this topic for both women and the professionals who treat them. The vast experiences
of a postpartum woman, whether at home with her baby, in her doctor’s office, in a therapist’s office, or
discussing her leaking breasts with a neighbor, are profoundly intimate. With her tremendous bodily changes,
her relationships, her expectations of perfection, her self-esteem, her sleep deprivation, her racing thoughts,
and everything in between, everything suddenly feels up close and personal. Even under the best
circumstances, when everyone is healthy and happy, unpredictable days are long, nights are longer, and
adjustments are made on a minute-by-minute basis. All too often, the unique needs of a postpartum woman
slip through the cracks of the medical and social community at large.
We have also found that a large number of postpartum women are surrounded by supportive friends,
family, and healthcare practitioners who may not have accurate information regarding the symptoms of
distress during this vulnerable time. In fact, many women come to our clinical practices after previously seeing
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one or more clinicians who, unfortunately, have misconstrued the circumstances and unwittingly exacerbated
the anxiety.
Thus, we were struck by the concurrent need for both postpartum women and their healthcare providers to
have access to accurate information. Could we effectively speak to both—the mother who is struggling and
the healthcare professionals and therapists who are in a position to help her? One may be desperately trying to
cope with terrible thoughts in her head, and the other is seeking state-of-the-art assessment techniques and
treatment options, as well as the research to back them up. We concluded that because of the intimate nature
of this work and the potential urgency for accurate information, the mothers and their providers could be
served by the information in these pages.
The bottom line is that both mothers and providers are searching for and are in desperate need of this
information. For this reason, we decided to speak to both simultaneously. At certain points in the book, it will
be evident when our emphasis is directed to the mother or to the healthcare provider. However, it is our
fervent belief that each can bring what has been learned into the other’s realm. At the end of each chapter, we
offer a summary in the form of a Take-Home Point for Mothers and a Clinician Note.
Our final set of challenges was the merging of our two very different voices. Karen would flippantly claim
that she was the touchy-feely part of the book, or the enthusiastic writer, and that Amy was the academic,
providing the conceptual framework. This may be true, but as it happens, Amy’s robust academic and research
background and Karen’s extensive clinical experience created a perfect combination of energy and expertise for
this delicate subject matter.
With these challenges carefully considered and sufficiently under control, we are confident that our readers
will find the information and support that they need. In moving forward, readers will gain a deeper
understanding of the phenomenon of unwanted thoughts during motherhood, including how common they
are, why they occur, and what a mother can do about it.
HOW TO USE THIS BOOK
The tone of the book is geared toward you, the postpartum woman who may be struggling with scary
thoughts, although it is important that healthcare professionals be aware of and integrate all the information
into their practice with postpartum women. This book provides a much needed resource for mothers and
clinicians who are forced to confront these negative thoughts by outlining the precise nature of these thoughts
and how to manage them. These topics will be discussed within the context of motherhood, keeping in mind
that some readers are not clinically anxious or depressed and that some are experiencing these troubling
thoughts as symptoms of an anxiety or mood disorder. Having this information at hand will provide initial
relief and help to normalize the experience, as well as augment recovery if a reader is in treatment for a
postpartum anxiety or mood disorder.
This book is divided into three sections. Section I, What’s Going On, contains definitions of various types of
scary thoughts and provides a context for how common these thoughts really are. Section II, Clinical Concerns,
explores the barriers to disclosing these thoughts and the screening and diagnostic implications for healthcare
practitioners. In Section III, Breaking the Cycle of Scary Thoughts, we explore actions women can take
immediately to feel better and continue to apply as they navigate their personal experience. Within this last
section, in Chapter 11, we have included a personal treatment plan for the reader to keep a record of
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experiences and progress. Some women might find it helpful to check in with this chapter while they are
starting the book and keep notes as they go along. Others might prefer to wait until they reach Chapter 11
and then put together a treatment plan after integrating what they have learned. Readers should rely on their
personal styles and use this book in whatever manner is most helpful to them.
Readers should be careful to read the parts that pertain to them and be mindful of any triggers that may
heighten their anxiety. It is not uncommon for books on distressing thoughts and emotions to aggravate
anxiety to some extent, but we are hopeful that if they stick with it, readers will find the support they need to
persevere until they achieve the relief they are seeking.
If, at any point along the way, you think that reading this book is making you feel worse, put it down. You
might want someone you care about to read it and then discuss some of it with him or her. It is our hope,
however, that you will be validated and reassured to read that what you are experiencing is a universal human
condition that is not unique to the postpartum period, though it is definitely amplified during this time.
This is not easy work, and you should be commended for your effort to confront that which is frightening
you. Even if your effort is completely driven by fear and you don’t necessarily feel you deserve credit for
confronting it, any energy you put forth toward acknowledging your experience and seeking support for it is
indeed praiseworthy. Reading this book, along with your commitment to learn more about what is frightening
you, is your first step toward reclaiming control in your life.
Karen Kleiman
Amy Wenzel
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