Mommy Guilt, Part II: Case Illustration

Consider a client I will call Cameron. Cameron had been treated for depression during her early and mid twenties, and so she was familiar with the symptoms. She was also committed to treatment without medications because she was nursing her son and she very much wanted to be a “granola mama.” When her husband brought her in, she had that wild, dear-in-the-headlights look about her that we’re all familiar with. She hadn’t slept well in days and was starting to feel loopy; she knew she needed help.

Her husband was very solicitous but didn’t seem to know what to do or say to be helpful, and not knowing left him feeling powerless and afraid. Cameron hastened to tell me that she didn’t want to go to the hospital—for one thing they had lost their health insurance when her husband was laid off, and the cost would bankrupt them; her mother was paying for some sessions with me. She was desperate, determined, and terrified—of what just wasn’t all that clear.

Earlier in the day she had reached out for help: she called her husband and mother in tears saying she didn’t know what to do and she was afraid she would hurt the baby. They both came running and that’s how she got the appointment with me. “On purpose?” I asked, referring to her fear of harming the infant. “No, not on purpose,” she replied, shooting me a look of horror. Then, softly, averting her eyes: “But you never know…that woman who drowned her babies…” Her voice trailed off.

“You don’t know?” I replied in classic therapy speak, genuinely curious but not at all alarmed. “Well, I mean, how would you know? Did she know? Is it possible?” Cameron’s voice trembled. “How, is a very good question” I countered “I like ‘how’ questions much better than ‘why’ questions because you can answer ‘how’ questions and I’m pretty sure that over the lifetime that lies ahead you will hurt his feelings, and he yours—maybe even a lot, certainly more than you wish.” Caught off guard, Cameron looked me straight in the eyes and cocked her head to one side—curious, entranced. I continued: “and sometimes, if you’re doing your job as a mom at all well—you do know that the standard we shoot for is ‘good enough’ mothering, don’t you? Because ‘good’ mothering just isn’t possible, and who would judge anyway, maybe there is a blue ribbon commission on Facebook or maybe the blue ribbon panel is just an imaginary one. Of course even the imaginary ones can be pretty powerful at times—but if you’re doing your job as a mom there will come a time when you set limits and he lashes out and says he hates you and maybe even thinks you’re a monster.”

Cameron smiled; her husband’s jaw and shoulder’s relaxed as he watched the interplay between us. “But I don’t know what to do,” she protested, “and today I looked at him playing on the bed and I just felt so overwhelmed because I didn’t know what to do—so I called Carter [her husband] in a panic.” I returned the puzzled look: “But…I don’t understand…you were doing something…you were watching him play. Isn’t watching a do-word? I suppose you could have talked to him, even though he can’t understand the words, and talking is another do-word.”  The session continued in this vein, with my eliciting descriptions and then puzzling as to why she would choose to interpret what she described in just that way, over and over again emphasizing the words choice and think or choose and imagine hypnotically driving home the idea that thoughts are choices.

Eventually, I concluded with a suggestion: “You can choose to imagine a terrible, horrible, no-good, very-bad future, or you could choose to imagine a magnificent, grand, and glorious future. Either way, it’s your imagination, and, inasmuch as this is your imagination, you get to choose which way you want to play it. If choosing to imagine something wonderful feels better than choosing to imagine something terrible, it seems to me that choosing what feels good would be the better choice in this situation. Of course there is another choice, and that is to stay in the present and not imagine the future more than you absolutely need to.”

There was no formal hypnosis; no induction, no swinging watch or levitating arm, no counting down stairways or floating on clouds, just a rapport trance, playful banter, and the careful association of choice and thought repeated many times and concluding with the suggestion of mindfulness. Interspersed throughout were instances of calling her attention to her own competencies and giving her permission to experience motherhood as a learning curve instead of a pass/fail test. Periodically I would ask her husband a question designed to elicit his affirmation of her competencies and his permission to learn instead of having to get it right and the suggestion that this is precisely the kind of support she needs—reminding of her competencies and permission to learn by trial and error.

Her homework was to notice everything she could about her baby and to experiment with different things, noticing the effect and making careful mental note of context cues: notice whether the baby follows your movements, notice his response when you speak to him or when you sing, notice how his face changes color when he’s pooping, notice the muscles in his face at different times during the day or during different activities. During the next session I brought her back to the question she had asked in the first session, asking “How would you know?” over and again in different ways, affirming her observations, and playfully insisting that she evaluate the results of her experiments for “rightness” until she was able to validate herself and think of mothering in less absolute terms.

I saw Cameron for six sessions—once a week and then on and off at varying intervals. When I last saw her about a stressful situation that had emerged at her work, the baby had had his first birthday and she was thinking about another. Her description of herself as “a laid-back mom, not one of the ones on Facebook” suggested that she had managed to unplug from the social mirror enough to claim her own identity as a mother. It doesn’t get any better than that.

Related articles:
Mommy Guilt: Put It in Its Place
The Imagination Is a Powerful Tool
I Think My Wife Has Postpartum Depression: What Do I Do Now?

© Copyright 2012 All rights reserved. Permission to publish granted by Sara Rosenquist, PhD, ABPP, Postpartum Depression Topic Expert Contributor

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Selena

    July 14th, 2012 at 4:02 AM

    For many women that whole mommy guilt issues is perpetuated by a husband who tells us we are not doing enough. In the case of Cameron though it looks like her husband is eager to tell her the things that she is doing right, even just the watching her son play. I think that most of us have thought at times that we are either not good enough for this role or are not prepared for it, but I think that we all need to cut ourselves a little slack. Being a parent is not easy, but if you just sit back and let it happen, most of the time it will come naturally to you. And give up on trying to be so perfect. No one is, but that doesn’t mean that you are not the perfect parent for the child that you have been given and blessed with.

  • Kayla

    July 14th, 2012 at 6:31 AM

    One of the biggest things that I see a lot of moms doing is comparing themselves to others and how someone else would manage a situation.

    Who cares what they do? If you are handling something and you know that it is doing your child no harm, than that’s enough.

    Any time you try to measure up to someone else you are never going to feel like you are living up to what or who they are. But if you would relax and take comfort in the fact that you are doing the very best that you can, then that should be enough.

  • Meryl

    July 14th, 2012 at 12:51 PM

    why do most women burden themselves with things so often? If you’re doing fine with your baby (or anything under consideration) then there is no need to see others or imagine and think too much putting yourself under stress, just calm down and work on things as they comes, you’re gonna fine, ladies.

  • Robyn

    July 14th, 2012 at 1:47 PM

    I don’t believe all of this petty whining that this girl Cameron made in this presentation!
    This is an obvious ploy to get attentiion when she thinks that it is being diverted from her by the birth of her child!
    Wasn’t there anyone who could see through all of this manipulation and see her for what she was, namely selfish?
    Yes she may have come through this alright and thankfully so did the baby but I get very annoyed reading all about these so called tales of mommy guilt or blues when to me what most of it sounds like is some desperate ruse to get a little bit of attention for themselves.

  • OWEN

    July 14th, 2012 at 3:34 PM

    I’ve had big depressive episodes in the past and it really does make you think about things that you normally wouldn’t…there is that constant worry in your mind and its just so hard to escape that feeling…I am hopeful women like Cameron get help ASAP because it can get even worse soon after a baby when you have already been through so much on a physical and a psychological level.

  • jade

    July 15th, 2012 at 7:39 AM

    sometimes when we are under stress or are depressed we tend to view things in a negative light, no matter what it the mother has been good in her role but she still has doubts.I think a regular habit of positive thinking can help us avoid and overcome such thoughts where there is no real need of self-criticism but we are doing fairly well.

  • Tessa B

    July 15th, 2012 at 4:03 PM

    Are we confusing depression with fear and unpreparedness? Because if that’s the case then there are some simple solutions for getting over that. If this is a clear case of post partum depression though, this is not something that you can just overlook. What if she did go off the deep end and then become one of those moms in the headlines? We can’t afford to ignore something, not until we are sure of what it is and that we are offering our help to the parents in need.

  • Willow

    July 16th, 2012 at 4:23 AM

    At least this was a mother who knew that she needed help, although she wasn’t sure exactly how to make this happen.

    There are many other mothers in this type of situation who don’t even realize that there is something bad there beneath the surface, they don’t know how to ask for help.

    And the people in their lives refuse to see that there could be an issue.

  • cecilia

    July 16th, 2012 at 10:59 AM

    Is there no daddy guilt?
    Again, everything piling up on the moms!

  • Rochelle

    July 17th, 2012 at 8:39 AM

    I couldn’t comment from personal experience but my very best friend is a first time mother, and even though she has years of experience as a child care provider and infant mental health specialist, she still carries with her guilt of not knowing what to do at times. I guess I think that because she has so much experience (personal and clinical) that she would not feel guilty or so burdened but I suspect those feelings come from a the social fabric which has sent her the message, time and time again, that she has to be ‘super mom’ all.the.time.

    And then we get together for coffee and remind each other that we’re simply moving through our lives the best way we know how…

  • Carolyn

    July 17th, 2012 at 12:32 PM

    I think that a lot of times women feel at odds because they are overwhelmed by the whole experience of being a good mom especially to a young baby. It is a brand new experience and no matter what the books tell you it is kind of hard to know what to do all the time until you actually get to experience it for yourself. the most important thing is to always try to surround yourself with friends and family who care about you and your well being and who will be there for you when you need a little time out for yourself.

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