Difficulties in the Treatment of Depression During Pregnancy and Postpartum Depression

Abstract

Treatment with women who become depressed during pregnancy or who develop postpartum depression can be challenging. In certain cases where women have a poor parental representation rooted in a negative relationship with their own mothers, a powerful resistance emerges and can take the form of abandoning the treatment. For women who have a history of abandonment by one of the parents, this particular aspect of the relationship may be repeated. In others, where there is a great deal of anger towards the parent, in spite of conscious wishes to be different, there is an identification with this negative parental image; the new mother feels herself to be a bad mother and flees the treatment as a way to protect the baby. Biological as well as psychological factors present during pregnancy and postpartum depression, as well as the impact of the mother’s depression on the developing infant are described and clinical vignettes are provided to illustrate the main points.

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Notes on contributors

Alexandra Cattaruzza

Alexandra Cattaruzza is a Psychoanalyst in private practice in New York City, and is Faculty and Supervisor at the Metropolitan Institute for Training in Psychoanalytic Psychotherapy and the Harlem Family Institute. She is a graduate of the Anni Bergman Parent-Infant Training Program.