Using Internal Family Systems (IFS) with Perinatal Women

The perinatal period is defined as the period “all around” birth, including pregnancy and the entire year after birth. Perinatal women experience rapid and intense changes in their biology; hormones are in a dramatic state of flux, fueling and informing the dynamic physical transformations of pregnancy, birth, breast-feeding and attachment.

15- 20% of new mothers experience what's referred to as a Perinatal Mood and Anxiety Disorder (PMAD), more commonly called “Postpartum Depression”. The rising and falling of hormones necessary for conceiving, sustaining, birthing and breastfeeding a baby influence mood and perception in the mother. Along with this riveting hormonal flux there is sleep deprivation accompanied by stress from major life and identity changes. Women are often exposed to other disruptive experiences like birth trauma, infertility treatments, and pregnancy or fetal complications. These potent factors create susceptibility to more “regressed“ emotional states or in the language of IFS, the emergence of exiled parts and protective parts. The typical biology of pregnancy and new motherhood therefore, brings a heightened sense of vulnerability to many perinatal women, whose internal systems then react protectively. Postpartum Depression is a catch-all term that describes manager parts and firefighter parts that have moved in to ward off older, deeper internal injuries that now seem to be leaking their pain into everyday life. Exiles threaten to “break out” and the entire system sounds an alarm. It's this alarm that brings perinatal women into therapy, with symptoms like intrusive thoughts, anger, panic, regret, shame, insomnia and despair. Becoming a mother forces women to reckon with their own feelings about dependence and vulnerability and this reckoning is a rare and valuable opportunity for healing.

By making the metamorphosis of early motherhood into a medical disorder, the magical, painful, transformative nature of motherhood is pathologized; mom is now “disordered” which often translates in her mind to “not a good mom”. When a brand new mom feels like she is abnormal and disordered, she becomes disconnected from Self Energy. She loses confidence, courage, calm, connectedness and clarity, which degrades and diminishes bonding and presence with her baby. She often becomes identified with her diagnosis, which is a description of her parts - the ones that desperately need attention and support. While identifying with parts is problematic and limiting, it’s also true that diagnosing this new mom can offer her normalization and a feeling of belonging. She’s no longer the only one having this painful experience and it’s something understandable. There are many cases of perinatal mood and anxiety disorders where it’s been in a woman’s best interest to be diagnosed because the diagnosis focuses and rallies her support team, allows her additional time off work, and shifts her into taking her needs seriously and looking for as well as accepting help. These actions all move a new mom closer to healing and care, provided she receives the kind of care that actually meets the needs of her internal world.

What is it that fundamentally needs healing and care in new mothers? New moms come face to face with whatever unfinished business exists in their soul or psyche around dependency and unmet needs for belonging. Manager parts that have kept our vulnerable exiled parts at a distance no longer function well with the biology and the circumstances of new motherhood. New moms no longer have their trusty filters or shields. They are just in it, in the soup of their deepest emotional vulnerability, awash in all the need and the fear associated with being so dependent. Like all of us, their parts have worked so hard since childhood to distance them from this experience of powerlessness — and now it’s back. Early motherhood plops us in the front row, center stage, rudely exposing us to the gyrations and howling of our oldest, most primal pain and now it’s singing in our faces, dripping sweat right on us. And with a baby in our arms, there is no way to escape.

If 20% of mothers are “disordered” during this critical developmental period, what does that mean for the fate of our world? How we as a culture think about women and mothers says a great deal about our collective values. If mothers are labeled “disordered” because of the emotional struggles inherent in the biological and spiritual changes required to support new life - as well as the emotional struggles that come from inadequate social support - if this is women’s “disorder” - I smell patriarchy, contempt, prejudice, hostility and the dismissive belittling of women. Perinatal women are in the middle of a physical, spiritual and psychological transformation that is the result of a natural developmental experience. Strange and intense feelings aren’t a sign of being broken; this woman is becoming something wildly different, because she has to. Mothering is the very heart of our humanity. Moms hold our physical and emotional vulnerability in ways that determine our wellness. There is no one with greater social or biological influence on us. Mothers give us our primal, underlying experience of life, of safety, of what it is to be known, seen, cared for - or not to. Every one of us is invested in every mother because mothers have primary, formative access to the wellbeing of humanity. Patriarchy holds vulnerability with contempt and our culture remains largely patriarchal. The unique vulnerability of perinatal women and the vital benefits of protecting and supporting women in staying vulnerable and open requires moving out of patriarchy and into the honoring of matrescence.

What all new moms truly need is compassion, connection, curiosity and care from our loved ones and from society at large. IFS is a conveyor of this respect and kindness. Working with new moms using this model sets up and establishes an optimal way of relating, internally and externally. Recipients of IFS internalize its respectful, open and caring qualities and begin to relate to themselves with more softness and interest. As a new mother’s internal world becomes friendlier and less burdened by old pain, she is able to respond more fully to herself and her children. Her presence and responsiveness creates fertile ground for growing secure attachment, the basis of human kindness, which our world desperately needs. New moms need to receive abundant, attuned and supportive care during this vulnerable time of life. When this happens, through a ripple effect, our society will become one in which mothering, with it’s dark, difficult crevices, is held in it’s wholeness as the most highly honored and worthwhile endeavor of human beings, for the way in which it opens up and heals women, and for the way in which it infuses new lives with love and belonging.

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Written by: Jessica Sorci, LMFT