An infant’s experience of postnatal depression. Towards a psychoanalytic model

Abstract

Despite the high prevalence of postnatal depression (PND) and the focus in psychoanalytic theory on the importance of the infant’s primary relationship with the mother, few case studies have been published. This applies to PND mothers in psychoanalysis and mother–infant dyads in psychotherapy. A case of a girl in treatment from 16 to 40 months of age is presented in three clinical vignettes. She was first in treatment with mother and then continued on her own in regular child analysis. Her main symptoms were restlessness and craving for the breast, later followed by a fear of holes and a phobia of ghosts combined with difficulties falling asleep. Based on this case, a psychoanalytic model is suggested of how the infant might experience being with the PND mother. The author suggests that infants of such mothers do not react to their depression per se but to a faltering containment. This leaves the baby with frightening emotions. The experience of insufficient containment may be represented in different ways such as, in this case, a fear of holes and voids and, in the next step, a phobia erected in defence of this fear.

Keywords:

• Postnatal depression
• infant development
• mother–infant psychoanalytic treatment
• mother–infant psychotherapy
• absent object
• containment

Acknowledgements

I wish to thank Beate’s parents for giving permission to publish anonymised case material. The paper was supported by grants from Ax:son Johnson, Children’s Welfare, Olle Engkvist Byggmästare, Groschinsky, Jerring, Kempe-Carlgren, Mayflower Charity, Solstickan and Wennborg Foundations and the Research Advisory Board of the International Psychoanalytical Association.