Postnatal depression : a relational perspective
Current research conceptualizes postnatal depression as individual pathology or as a socio-political problem. By adopting a relational perspective, this thesis bridges the theoretical divides between individualistic and social explanatory frameworks, and between psychology and sociology. The self is seen to be essentially relational, and postnatal depression understood in terms of interrelationships between an active self, others and society. In-depth interviews were conducted with 40 mothers of young children living in Britain, recruited through community sources. Mothers defined their own psychological state following childbirth: 17 found motherhood unproblematic; five had difficult experiences which they distinguished from 'postnatal depression'; 18 experienced, what they defined as, 'postnatal depression', after the birth of their first, second or third child. These 18 mothers are the central focus of the study. The data were analysed using Brown and Gilligan's (1992) 'voice-centred relational method'. Key methodological and theoretical concerns include: listening to mothers on their own terms; considering the interpretations and meanings mothers attribute to their experiences; theorizing similarities, and differences, amongst mothers; exploring changes within individual mothers over time. Postnatal depression was characterized by, and resulted from, a psychological process of relational disconnection, in which mothers felt alienated from themselves and others. During the depressipn, they believed their moral worth and social acceptability depended on complying with cultural expectations of motherhood. The 12 first-time mothers felt under pressure to conform to normative definitions of the 'good', selfless mother. All 18 mothers felt under pressure to conform to a cultural ethic of individuality and self-sufficiency. In order to protect their own integrity, and preserve their relationships, mothers actively withdrew their needs and feelings from relationships with their children, partners, relatives, friends, other mothers with young children, and health professionals. This social withdrawal was distinct to, and occurred irrespective of, physical isolation and unsupportive relationships. Although the mothers conformed, they also questioned cultural norms which construct the needs of self and other as separate, competing forces. During the depression, their resistance was a silent one. The move out of depression was accompanied by shifts in the mothers' moral beliefs about themselves, others and society. They felt it morally acceptable to attend to their own needs and those of others. Relationships with other mothers were critical to these moral re-evaluations. They enabled them to openly question normative constructions of motherhood, providing them with the possibility of a voiced resistance. Policy implications of this research are considered in terms of prevention and intervention programmes for depressed mothers.