Week 4: Maternal mental healthh and impacts on family Flashcards
Early thoughts about maternal/child relationships
Sigmund Freud- considered that the infant was driven by forces from within the infant. ‘Instinctual drives’, these were drives for death and sex- ‘Eros and Thanatos’.
It led to the idea of ‘repression’, the individuals attempt to supress these powerful drives
Has led to Freud being dismissed, however, he was the first person to consider the concepts of the child as a being- also writes beautifully. He also gave us the concept of the ‘unconscious’
What is the attachment theory?
John Bowlby- psychoanalyst and paediatrician who was
originally influenced by the Freudian/Kleinian school of
thought.
Broke away from the Freudian school and was
subsequently rejected by the Freudians as he developed his
theories related to attachment and more importantly, to
loss.
Loss had not been regarded as significant by Freud
What did Bowlby say about attachment and loss?
Bowlby developed the theory that infants are born seeking
attachment to another.
He noticed that the child sought contact immediately after
birth.
Was interested in noting that the child could not survive
without the other- humans have developed to such an
extent that their brain is too heavy at birth.
Entirely reliant on the help of another
An internal working model
The child’s attachment relationship with their primary caregiver leads to the development of an internal working model
This internal working model is a cognitive framework comprising mental representations for understanding the world, self and others.
A person’s interaction with others is guided by memories and expectations from their internal model which influence and help evaluate their contact with others
What are the characteristics of secure attachment?
As a child- able to separate easily from the parent, seeks comfort from parent when sacred or anxious, greets the parent positively on their return. Prefers parents to strangers.
As an adult- have trusting adult relationships, tend to have high self esteem, are comfortable sharing feelings with close others and seek out social support
What are the characteristics of ambivalent attachment?
As a child-may be wary of strangers, become greatly distressed when parent leaves and do not appear comforted when the parent returns
As an adult-reluctant to become too close to others, worry that their partner does not love them and are distraught when relationships end
What is disorganised attachment?
Main and Solomon (1986)
Age 1 year- may be showing a mixture of avoidant and resistant behaviours. May appear dazed or confused, bewildered.
Age 6 years-may take on a parental role or become a care giver toward the parent
What are the possible causes of unhelpful attachment styles?
Physical neglect — poor nutrition, insufficient exercise, and neglect of medical issues
Emotional neglect or emotional abuse — little attention paid to child, little or no effort to understand child’s feelings; verbal abuse
Physical or sexual abuse — physical injury or violation
Separation from primary caregiver — due to illness, death, divorce, adoption
Inconsistency in primary caregiver — can mean many changes or emotinal inconsistnecy
Frequent moves or placements — constantly changing environment; e.g. children who spend their early years in orphanages or who move from foster home to foster home
Traumatic experiences — serious illnesses or accidents
Maternal depression — withdrawal from maternal role due to isolation, lack of social support, hormonal problems
Maternal addiction to alcohol or other drugs — maternal responsiveness reduced by mind-altering substances
Young or inexperienced mother — lacks parenting skills
What are the mental health problems related to attachment?
Increased risk of depression and anxiety
Inability to ask for help or support can have an impact
Dissociative states when faced with trauma
Personality disorders
Associated problems as a result of a challenging upbringing and socio economic factors
How does cortisol levels impact brain development?
Cortisol levels during pregnancy may have an impact on fetal development
Delicate development of brain structures- plasticity allows for increased vulnerability but potentially therefore for therapeutic intervention.
Recent studies show much room for improvement (plasticity) so may call into doubt some long held ideas about attachment
What is the idea behind the neuroscience of attachment?
‘in our brain each of us has his or her own….finest drugstore
available at the cheapest cost to produce all the (emotion
chemicals) we ever need to run our body mind’ Pert 1997
Oxytocin
Opioids
Prolactin
Dopamine
GABA
Serotonin
How can we support families and parents?
Building on attachments- talking about attachment Talking about past and family life Being mindful of the mothers past history if this is shared or of current challenges Understand the mothers style of attachment- noting resilient aspects- ask to complete a questionnaire Build on the possibility of prenatal attachments developing through your intervention Promotion of changed chemical experience during pregnancy
