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“Every time I would descend a stairwell with baby Nila,* I imagined us falling. The nightmares vary — sometimes I fall on her, other times she cracks her head. Sometimes I just shake my head to make the ugly thought go away.”
Molly* sat in front of me, her body tangled but limp like a loose ball of yarn, peering at me timidly through her fingers, a vulnerable adult version of peek-a-boo. She continued to slowly describe what she referred to as her "day nightmares."
As I sat and listened without judgment, Molly’s body slowly relaxed and unfolded. I helped her understand that these are intrusive thoughts — they come on their own without invitation — and as scary as they may be, they are actually quite normal.
Karen Kleiman, an international maternal mental health expert and author (2012) writes that over 90 percent of mothers will experience scary thoughts postpartum. However, when these thoughts are cast to the shadows out of fear or shame this can perpetuate a cycle of anxiety, depression, and possibly self-harm.
One way to understand the nature of scary postpartum thoughts is by empathizing with a mother’s sudden role as the primary caretaker, responsible for the wellbeing and protection of a precious new little life. Add in our current global climate and mother's daily worries are compounded by the unknown and isolation of the pandemic.
For many, predicting and "playing out" potential worst-case scenarios is the mind’s way of creating a sense of temporary control — “magical thinking” if you will. Even if the thought is horrifying, we tell ourselves that it somehow feels less scary if we have predicted its possibility — witnessed its horror.
Prominent English paediatrician and psychoanalyst Donald Winnicott (2012) coined the term "maternal preoccupation" to describe the early mental process of a mother’s mind being constantly focused on her baby. He depicted the optimal "holding" environment for a new baby to thrive as one in which the mother is psychically and physically present for the infant’s needs.
So, evolutionarily, a new mother may be hardwired to be constantly physically occupied with her newborn baby’s needs (diaper, feed, nap repeat!), as well as mentally occupied by nap times, feed times, and concerns over the baby's physical and emotional safety and health.
Winnicott explained that it is the mother’s mental preoccupation and sensitive response to the baby that facilitates a secure attachment bond, grounded in mom and baby tuning in to one another’s feelings, thoughts, and behaviors. Indeed, there is a plethora of scientific evidence to support the normalcy of maternal preoccupation and the important role of maternal sensitivity and attunement in creating a secure attachment (Ziv, Oppenheim, & Sagi-Schwartz, 2004; O’Conner, Heron, Golding, Beveridge, & Glover, 2002).
Moreover, there is neuroscientific evidence to support neuroplasticity in a mother’s brain (Hoekzema et al., 2016) which helps her mind attune empathically to her baby’s experience while devoting less brain space to more trivial details like recalling what was for dinner the day before or where you left your phone (the phenomenon behind "mommy brain").
Even though worrying is part of a normal maternal mental process, this preoccupation can cause a mother undue distress. In some cases, a mother’s anxiety feels inescapable, which makes even basic decision making difficult and can compromise her finding pleasure in daily life (and mothering).
Scary thoughts that feel all-consuming and/or interfere with daily functioning — or the development of behaviours to attempt to ward off the ‘bad’ from happening — are potential signs of postpartum anxiety or postpartum OCD. Indeed, If a new mother finds herself wondering whether her worries and scary thoughts are too much- or she struggles to know what is real or not real- it is very important to seek professional opinion and support. A mother should not feel alone and plagued by these thoughts.
A word on trauma: If a new mother has experienced an overwhelming, incomprehensible, and devastating psychological experience (be it in childhood, through her lifespan, in pregnancy or previous pregnancies, or in labor or birth), scary thoughts can emerge as a fear of the experience recurring or as a fear of something else uncontrollable happening. Right now amidst this global trauma, it is possible that like a lighthouse, the mind starts to scan the environment for the next ship — the next bad thing — as if catching it before it happens will keep her safe. This form of ‘hypervigilance’ gives power to the scary thought. For example, a common belief might be that the scary thoughts are a form of self-protection and protection of the baby; by obsessing/not taking her mind off of the bad that may happen mom feels she can control it.
Returning to Molly, what helped her was the process of me (as the therapist) bearing witness to her scary thoughts- non-judgmentally and with compassion. I believe that as Karen Kleiman so eloquently writes, it was the power of holding which allowed Molly to disempower these thoughts. If you’re experiencing scary thoughts, what can help?
Normalize your scary thoughts. Sharing scary thoughts with a trusted friend, family member, or professional helps with tolerating their presence and disengages the thought from reality. Thinking a thought does not mean it is real or going to happen in any way.
Noticing and not clinging. The goal when experiencing scary thoughts is to be able to notice these thoughts, acknowledge them, and then let them go. Think of yourself like Teflon (nonstick pan) when an uninvited thought comes in. The practice is to notice the thought- give it a nod- but not cling. Allow the thought to move past (and through) you like clouds in the sky or suitcases on a conveyor belt. The more you engage in this practice, the stronger the brain's muscle of ‘nonstick’ becomes.
Mourning losses. Motherhood is replete with paradox and there are many changes and losses that come with having a child (from the first time to the fourth time!). It is common to avoid talking about ambivalent feelings, feelings of loss and of regret because these thoughts feel embarrassing or shameful. The problem is that perceiving maternal ambivalence as unacceptable, or as evidence that a mother is "bad" can make scary thoughts more pervasive. The secrecy and shame increase feelings of sadness, loneliness, and guilt which perpetuate the scary thoughts themselves in an unfortunate feedback loop. Instead, radically accepting all the complex feelings of motherhood, allows us to move through feelings each one giving way gently to the next.
If you would like to consult a professional about your experience of worries and scary thoughts postpartum, you should always feel you can. It may be normal to worry as a new mom, but you should never be suffering in your worries. If you do not know where to turn, you can always look at PSI (Postpartum Support International) and PostPartum Stress Centre for a list of professionals trained in perinatal mental health in your area. Remember that you are not alone.
*Name and identifying information changed for confidentiality purposes. Clinical reference provided with consent.
