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Postpartum depression is not a moral failure, an ethical dilemma, or a symptom of weakness. It is a medical condition that often began long before the baby was delivered. It is a neuropsychiatric illness that affects every cell in a woman’s brain and body, some more obviously than others. But women who develop it rarely see it as a true medical illness no less real or serious than postpartum thyroid disease. Unfortunately, the same lack of insight plagues partners and clinicians in all too many instances. |
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Postpartum depression robs a woman of what can be one of the most spectacular and truly unique experiences of her life. Even in parts of the world where famine, disease, and violence daily threaten people’s very existence, the birth of a child is greeted as a miracle and a symbol that all may be better some day. But postpartum depression sucks the lifeblood out of a mother and can torment her with guilt over bringing a child into the world. Postpartum depression can make the most optimistic woman question her very existence. And for the other parent? The shock of seeing one’s partner not fall in love with her baby can leave gaping holes not just in the relationship, but also in the partner himself or herself. Postpartum depression is an illness that touches the immediate family, the extended family, and the woman’s friends. Therapy and the Postpartum Woman: Notes on Healing Postpartum Depression for Clinicians and the Women Who Seek Their Help presents a brilliantly written guide that is distinguished by its recognition of the biological nature of postpartum depression, while acknowledging that the term “postpartum depression” belies the complexity of perinatal mood disorders. Ms. Kleiman stresses that psychotherapy is not a substitute for medications when somatic treatments are necessary. Instead, she works from the premise that, when used judiciously, psychotherapy is an essential therapeutic tool that can facilitate complete recovery by addressing the unique challenges posed by perinatal mood disorders. |
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Ms. Kleiman presents a theoretical framework in which the therapist “mothers the mother” by acting as the “good” mother, who “must achieve that equilibrium between absolute support and appropriate boundaries.” Using compelling patient narratives, she demonstrates just how to achieve that balance in order to teach the patient how to develop confidence in her own skills as a mother. There is a treasure trove of “clinical pearls” in this eminently readable book, which even the most experienced clinician will be able to use right away. For those new to the field, and for patients and their loved ones, the book offers a wealth of information on the nature of postpartum depression as a medical illness and the psychosocial issues that arise when a woman is faced with caring for a baby. Ms. Kleiman describes how the medical community tends to minimize the complexity of these issues and use a “one size fits all” approach to treating depression. Readers will learn to be more effective advocates for proper treatment of perinatal depression. Therapists will also learn how to draw from their own experiences to facilitate the human connection between therapist and patient at a time when women feel isolated by shame and insecurity. Together, the therapist and the patient can work towards discovering the innate resilience that has allowed women to raise children even in the most extreme circumstances. Ms. Kleiman has developed a humanistic approach to psychotherapy for postpartum mood disorders that gives recognition to psychodynamic theory, but then uses many cognitive–behavioral techniques to reach well-defined goals. Therapy and the Postpartum Woman is an elegantly written book that not only offers practical advice but also does so in a way that will touch the lives of both patients and therapists. It is destined to become a classic for those experiencing or treating perinatal mood disorders. |
