Friday 31 October 2014

Patricia Casey: Mothers must let go of perfectionism

To avoid anxiety and adjustment disorders, new mothers should accept that being a 'good enough parent' is ok

Patricia Case

Published 11/08/2014 | 00:00

It's OK for mothers to be OK. (Picture posed)

I recently came across the acronym PFB (precious first baby) on mumsnet, the website for mothers. There was a slightly tongue-in-cheek and amusing piece, describing the lengths new mothers go to in order to achieve perfection in their new-found role.

The writer coined the term 'PFB syndrome' to describe the phenomenon. Of course, it's not a syndrome in the sense of being clinically relevant to a psychiatrist, but it did illustrate what many young mothers experience, what they tell me, and undoubtedly, what they discuss in their mother and toddler groups.

The examples range from the commonplace to the eccentric and extreme. One mother reported that she pulled her baby's buggy backwards for two miles because she hadn't put sunscreen on his face. Another talked of warming cucumber pieces in a microwave because they might to too cold for the little lad, coming directly from the fridge. Then there was the usual account of waking the baby up to make sure it was breathing - a habit that most mothers, including this one, engaged in to a greater or lesser extent. And of course, the new first-time mother describes the feeling as similar to being in love, with thoughts of the little person filling their every waking moment.

These deeply-tender emotions stimulate protectiveness and nurturing. It is for this reason that tragedies involving children have such a profound impact on young mothers, who can identify with their suffering.

By the time the second child comes, the mother has acquired sufficient skills to know that holding a baby won't cause him injury (one mother wrote on mumsnet that whenever another person cuddled her baby, she insisted that he be placed on a pillow so as to avoid injury), or that her nipples don't need to be sterilised before every feed, as one mother recounted. She is now able to be a "good enough mother" (a term coined by Donal Winnicott, an English paediatrician and psychoanalyst), just like the rest of us.

For most women, the perfectionist phase is a nuisance, both to herself and to those affected, such as her own parents, her partner/spouse and those within her social ambit. For a small group, it goes beyond this and generates excessive and intrusive anxiety.

Most of the focus on those with post-partum mental health problems has been on postnatal depression, and correctly so, since this can be life-threatening for some. But recent research suggests that anxiety and problems adjusting to motherhood (known as adjustment disorders) are even more common.

While not life-endangering, they do have an impact on day-to-day living and interactions with others.

A study from the University of Monash, headed by Dr Karen Wynter and published in the Journal of Affective Disorders, in December 2013 makes for interesting reading. She interviewed 172 couples, six months after the birth of their first baby. She found that 33pc of mothers and 17pc of partners had either an adjustment disorder or an anxiety disorder - in other words, the behaviours described above had crossed the boundary into recognisable psychiatric illness. Interestingly, postnatal depression was absent. Fortunately, adjustment disorder and anxiety invariably resolve spontaneously or with basic support.

What is the impact of PFB on the child as they make their way through life? In reality, it is likely to be very little. There are some studies showing that first-born children have higher IQs. However, the difference is of the order of 3pc, and so, is unlikely to make any material difference to the child's future success or otherwise; that is unless the child aspires to attend an Ivy League university rather than a slightly lesser institution. And as the years pass from childhood to adulthood, so many other factors will intrude upon the child's development that the intensity of the mother's focus in the early years will have been subsumed by other variables.

Among these is the child's innate personality, the relationship between the child's parents, the relationship of the child to its parents, and the nature of other relationships that the child has with peers and extended family. Only if the superlative standards set by the mother persist, is it possible that the child will suffer adverse consequences, in a life driven by perfectionism and control.

The sooner the mother accepts that being a "good enough parent" is ok, the better for her and for her child. Because a good enough parent is still loving, nurturing and protective, but is also flexible, understanding and, ultimately, able to let go.

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