And is Where the Magic Happens: Supporting Mother-Infant Relationships
Written by Guest Blogger Megan Tavares, LICSW, PMH-C
Attachment Theory
I was first introduced to attachment theory early on in my counseling career, when I worked with a supervisor who was passionate about attachment and supporting young, vulnerable families. Fresh out of graduate school, I knew little of how to โdoโ real-world social work. I was eager for support as I learned to navigate a new position, new profession and what felt a bit like a new life in my early 20โs. As the youngest and newest staff member, I was the baby of the group and my supervisor was the mother hen. Looking back, itโs not lost on me that my own passion for attachment and supporting young, vulnerable families was born from this professional relationship, a parallel process mirroring the magic that can come from secure mother-infant relationships.
Holding the Mother-Infant Relationship in Our Mindโs Eye
According to D.W. Winnicott, the British pediatrician, psychoanalyst and early pioneer of attachment theory and the โGood Enough Motherโ in the early 1950โs,โthere is no such thing as a baby, there is a baby and someone.โ For a word that takes up little space on the Scrabble board, its ability to convey connection is huge. And is a reminder to those of us in this line of work that babies cannot be supported in isolation, even if they are the identified client on paper. Winnicottโs research and the work thatโs blossomed from those roots reminds us that babies are born โhardwiredโ to connect, that they enter the world innately knowing they are one half of a whole. It reminds us that itโs not nature versus nurture, but nature AND nurture working together, channeled through the love and affection of a primary caregiver.
By holding the mother-infant relationship in our mindโs eye, we put ourselves in a better position to meet the needs of dyads we work with. Itโs often a port of entry into difficult work when we view the relationship as a third client - statements such as โI can see how much you love your baby and I can see how much your baby loves youโ act as a healing balm for caregivers feeling defensive about needing support and being judged by others. Working with the parent-infant relationship as a separate entity deserving of its own case conceptualization, we help parents reflect on what Dr. Alicia Lieberman refers to as โghosts and angels from the nursery,โ giving them an opportunity to break family cycles and create healthy relationships with their little loves.
PTSD can happen to anyone that experiences any form of trauma. But mothers with PTSD are at heightened risk of other perinatal mental health conditions, like postpartum depression and anxiety. Experiencing birth trauma, therefore, increases the likelihood that women will experience mental health concerns during the fourth trimester.
Relationship Status: Itโs Complicated
Itโs important to acknowledge that dyad work is rarely straightforward, even for the most seasoned practitioners. To develop a holistic and accurate perspective on the parent-infant relationship, we also need to sort through what each half brings to the relationship separately and how all of those pieces come together to create the whole. Our mindโs eye is constantly zooming in and out to get a full understanding of what weโre seeing.
For many caregivers, the bond with their baby began well before becoming a parent. We imagine what life will look and feel like, what our intertwined lives will be like as the years go by. Weโre told itโs going to be love at first sight and to enjoy every minute of new parenthood. We develop a picture in our mind of what our baby will look like and be like. But reality rarely meets expectations. The birth of a baby often challenges everything we thought we knew about ourselves or how we thought life would be, and that level of self-reflection can be agonizing for even the strongest amongst us. Babies are certainly a gift, but they are also mirrors, reflecting back hard truths weโd rather forget.
Strategies to Support Mother-Infant Relationships
Considering the influence of psychoanalytic theory on attachment theory, itโs understandable if clinicians who donโt have a psychoanalytic background feel as though they lack the training and experience to fully support vulnerable dyads. In keeping the mother-infant relationship in mind and allowing this perspective to underpin the clinical work, clinicians who donโt have a psychoanalytic background but understand the importance of bonding and attachment are more than capable of doing this work. Through our use of self, weโre able to help mothers and other caregivers develop an embodied sense of relational safety, paving the way for our adult clients to do the same with their babies.
An attachment-oriented approach also lends itself nicely to cognitive behavioral therapy (CBT). Challenging and reframing unhelpful and inaccurate cognitions mothers have about themselves and their abilities creates space for the development of an accurate and helpful self-perception around their identity as a mother. As mothers hone their ability to challenge and reframe cognitive distortions, the mirroring between a mother and baby should become less triggering, allowing caregivers to be more emotionally available to their infant.
As we think about approaching the clinical work with mother-infant pairs in any way, itโs helpful to remember there are many simple strategies to support dyads that can have a huge impact:
Psychoeducation: Educating parents about the baby's cues can help caregivers strengthen their observation skills and become responsive to the baby's needs.
Referrals: Connecting families to relationship-based services like infant massage classes can also help strengthen observation skills while using safe touch to release oxytocin in both caregiver and baby. Referrals to other body-based services, such as craniosacral therapy and chiropractic care, can help alleviate challenges like sleep and feeding issues, which can impact bonding and attachment.
Sharing observations: Reflecting back what we, as professionals, observe between caregivers and babies can be helpful. This is also known as immediacy and is an effective strategy because our status as a professional increases the value of the validation for mothers.
When in Doubt, Look at Your Baby
We know mothers and other caregivers often feel they arenโt good enough. But the simple truth is, theyโre already doing a lot of great things, just by being themselves. Pointing that out helps caregivers see that bonds are built over time through small, consistent, loving interactions. I often say โwhen in doubt, look at your baby.โ They share how they feel about us every day - smiles, coos, eye contact, snuggles, calming when we pick them up - all love letters to mom, all cues that canโt be denied when they see them reflected back by their baby.
And truly is where the magic between a mother and infant happens, with each bringing their own pieces of the puzzle and fitting them together to create something unique and beautiful. But this sacred relationship is also where healing and growth take place, creating a new path forward for mother and child, hand in hand, heart to heart.
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Guest Author: Megan Tavares, LICSW, PMH-C
Megan Tavares, LICSW, PMH-C is the owner of Peace & Pearl Wellness and Counseling, a telehealth-only private practice focused on perinatal and early childhood mental health. She is also a freelance writer and has been featured in Insider, Edutopia, Parents.com, the TodayParents Community and Motherly. Megan currently lives in Southeastern Massachusetts with her husband and two sons.
About the Trauma-Informed Maternal Health Network
Liz Gray, LCSW and Olivia Verhulst, LMHC, PMH-C are the co-founders of the Trauma-Informed Maternal Health Directory. They are clinical psychotherapists with a deep passion for increasing accessibility of trauma-informed care to the maternal health population. They created this specialized directory to connect women experiencing infertility, pregnancy, postpartum, and new parenthood to trauma-informed health and mental health providers.
Search the directory: https://directory.maternaltraumasupport.com/
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