Updated: Mar 13, 2020
I remember nursing my newborn daughter and feeling an overwhelming physical thirst of emergency intensity nearly every nursing session. It felt as if I would die from not having liquid and my entire being was clamoring for more, more, more. I could drink 32 ounces and my thirst was still unquenched; I kept a large bottle of liquid at my side everywhere I went and I became anxious when it was more than half gone. The sensation of that thirst brought up a keen awareness of NEED in me, mixed with panic that I wasn’t going to be able to get the need met. It was as though the infant part of me that hadn’t gotten enough was reawakened every time I attempted to meet that particular need of my daughter’s. I experienced the need and the panic behind it as an indication that I was lacking something vital in myself. I think now that I was in fact glimpsing the psychological world of my own internal infant self, and that she had been left very thirsty, or the emotional equivalent of very thirsty in a way that had been terrifying and all consuming.
For most new mothers, the days, weeks and months following the birth of a baby are challenging and exhausting. And for some new moms the postpartum experience actually results in a crisis and a total or near complete collapse of self. I believe this subsection of new mothers who suffer so intensely in the postpartum period might be more deeply understood and more successfully treated if we consider them through the lens of character style, and in this case, specifically the oral character style (Johnson, 1994).
During the symbiotic phase of development, “there is no conscious differentiation between oneself and one’s caretaker” (Johnson, 1994). The infant experiences the mother as its self, and the mother too, has a sense of sharing her infant’s experience. This symbiosis is critical to survival in that it forces the mother’s attention to be always on her newborn in a way that helps ensure proximity and acute awareness of the newborn’s needs. If we accept the idea that mothers are in a sort of psychological lockstep with their babies, we can imagine that parents continue to experience the part of their self that is developmentally congruent with their child, simultaneous to the child experiencing that particular stage. Mothers of newborns are then thrust back into re-experiencing their own newborn infant self that has essentially been dormant in the unconscious prior to the birth of this new baby.
Our earliest psychological developmental task is embodying the capacity for attachment and bonding (Johnson, 1994); failures in this period result in schizoid and oral adaptations in the fundamental structure of the infant and later the adult. For mothers who suffer greatly in the months following birth, I believe it is often the case that their own early infancy was fraught with either harsh, aversive parenting (leading to a schizoid character style, typified by withdrawal) or deprivation and unreliability (leading to an oral character style typified by premature, exaggerated independence). It’s almost as though the birth of the baby forces the mother back in time to when she herself was an infant. If the mother was well cared for by an attuned, consistent, responsive other, that newborn part of her will likely be well resourced and able to draw from her own full tank to meet the needs of her young infant. But a mother who did not herself receive the kind of warm, attuned and empathic responses that a newborn requires for optimal development will find herself overdrawn and out of gas as she tries to nurture her own new baby. The meaning that she makes of her struggle and the way in which she responds to the crisis also tend to fall in line with her established character style.
Mothers who encountered developmental blocks after their early infancy will be challenged in other predictable ways as their children’s development progresses and pulls forth those characterological facets. Here I am focusing on the oral character style, as I have noticed the prevalence of “oral” traits in the new mothers I’ve worked with whose struggle to adjust to their new role is particularly painful. My hypothesis is that as clinicians working with PPD, we can be of immense help to our clients by supporting them in making the difficult leap into owning their own “neediness” and allowing their dependence to move to center stage.
The central theme of the oral character’s life is denial of her own needs. “Orality will develop where the infant is essentially wanted and an attachment is initially or weakly formed but where nurturing becomes erratic, producing repeated emotional abandonment, or where the primary attachment figure is literally lost and never replaced” (Johnson, 1994). “Essentially the oral character develops when the longing for the mother is denied before the oral needs are satisfied” (Johnson, 1994) and the child in effect has to grow up too soon. As an adult, the oral character suffers from “the inability to identify needs, the inability to express them, disapproval of one’s own neediness, inability to reach out to others, ask for help or indulge the self. The individual tends to meet the needs of others at the expense of the self, to overextend and to identify with other dependent people” (Johnson, 1994), effectively denying and projecting her own needs onto others. Her false self appears to be nurturing and helpful, but in truth she is desperate (perhaps unconsciously) for the kind of sustained care and love she did not receive. This false self is her “compensated” self – that part of her self that has learned how best to function in a world where her own needs could not be met, by being helpful to others and not acknowledging her own immense needs. She also has a “collapsed” self that emerges when the compensation fails, such as in the postpartum period. There is an ongoing fluctuation between compensated (sometimes grandiose and even manic) and collapsed (depressed) states that can appear cyclothymic (Johnson, 1994) in oral characters.
New mothers who fall into this oral category tend to describe themselves as having been “Type A”, controlling, and/or particularly independent, having identified with this compensated part of their selves. Sometimes it is the case that these women have histories of appearing to be highly functional, and prior to their postpartum period were superficially quite well adjusted, though they often report having lived with low grade depression throughout their lives. Metaphorically, it’s as though they’ve built a reasonably solid looking house on a very weak, incomplete foundation. Having a baby is the crisis that shakes the house so hard it completely collapses and reveals the jury-rigged structure beneath.
The postpartum period is a time when mother and infant need an extraordinary amount of external support. Oral characters tend to find themselves in family and social contexts that are consistent with their own style, meaning there generally aren’t supportive systems in place nor is there access to many helping hands, either because the mother is unable to relinquish control, reach out and trust others to help and/or because there actually aren’t helpful others available. Consequently, as the new mother is coming into a psychological reexperiencing of her old injuries from her early infancy (namely her sense of lack and of being a burden), mixed with absolute need for support in the present time, she is simultaneously re-injured in the same manner that caused her orality. Feelings of helplessness, terror and futile longing set in, all while she is “burdened” with the task of caring for another similarly helpless, terrified little being who continually echoes and reminds her of her own unmet need for soothing.
The therapeutic aim in working with new mothers who have PPD (or the like) and have had developmental arrests in their own infancies is to assist them in identifying resources and mobilizing adequate support as quickly as possible. This can be quite challenging when working with women who fundamentally don’t know how to ask for what they need and don’t feel entitled to receive what is offered. In my experience, helping a new mother to get over the initial hump of asking for and receiving, regardless of the discomfort she will feel, can make a profound difference in the emotional health of the entire family and in the outcome of PPD. The fact that she appears for treatment is a promising sign, indicative of receptivity. The window for attachment and bonding with a baby is finite (though generous), and I see it as imperative that mom begins to accept nurturance and sustenance for her self in the postpartum period so that she can genuinely nurture and sustain her baby. Without adequate sustenance for herself, she will undoubtedly though not deliberately, perpetuate the oral style in her child.
In her collapsed state, mom must be encouraged to go ahead and need, to go ahead and ask for and take in some of what she has always longed for and what she has secretly been enraged about never having received. It’s as though she has to transform her entire internal world and operating system to be one where it’s permissible to have needs, to speak up, to take in, all while learning to feed and care for and understand a newborn – and quite probably with little sleep! In therapeutic terms, what might be a prolonged, gentle and gradual approach in a non-postpartum period is by necessity a crash course in self-care in the wake of PPD. Although it flies in the face of my psychodynamic/analytic training, I find it necessary to bluntly state and firmly repeat a sort of mantra to these new mothers attesting to the naturalness of their immense needs in the postpartum period, the idea that mom is of little use to baby when mom is undernourished on any level, along with an ongoing, exhaustive review of all of her potential resources. As the crisis eases, we have the luxury of slowing the process down and understanding and exploring the nuances and particulars of her personal story.
In the postpartum period, many mothers with an oral character style have access to incredible feelings of need and longing in a way that is unfamiliar and overwhelming to them. Allowing those feelings to emerge, to be named, felt and then grieved is the beginning of a transformative healing process whereby they can begin to restructure their very character. We are gifted as mothers with an opportunity to readdress our early attachment wounds through the process of bonding with our own babies. But as adults we now have the power to bring words and consciousness to the experience, so that we can affect the outcome in ways that are consistent with our deepest values. A mother’s experience of postpartum suffering can be the undoing of her oral character style and also an opening for incredible developmental and characterological growth.
Written by: Jessica Sorci, LMFT