The Transition to Parenthood: Common Struggles & Taboos with Emotionally-Focused Therapist Nikki Lively

Women’s mental health and perinatal mental health has long been shrouded in taboo.

We asked the Clinical Director of the Transitions to Parenthood program at the Family Institute of Northwestern University in Chicago, IL, Nikki Lively, some of our burning questions around the ‘taboo’ topics of motherhood, including common struggles that new parents share.

We Asked: What common struggles do you see new parents facing that you think need greater exposure and understanding?

The ‘unmentionable’ topic I hear the most often from my clients continues to be that becoming a mother does not make them ‘happy’; rather they report feeling profoundly overwhelmed!

This is not a symptom of a postpartum mood or anxiety disorder per se, but rather something I see as partly a function of the way our society is structured — with each individual family living in relatively isolated households, and partly just the reality of how much, and how constant the work is of taking care of a baby. 

Why don’t we talk more about this challenge?

The reason this seems to be unmentionable is that women are still under tremendous pressure to ‘be a good mother’. If you are asking, “what does this really mean?” that’s a great question that no one seems to know the answer to, and is a moving target! (I could go on and on about this topic as well!)

However, the one thing that everyone seems to agree on is that a good mother loves being a mother. So if women acknowledge that the day to day experience of being a mother is actually rather tedious, maybe even boring at times filled with tasks you would rather not do (like cleaning out a crib full of poop after what I lovingly call a ‘blow out’!) then they fear the shame of feeling and/or being seen as ‘a bad mother’ and then sadly aren’t able to get the emotional support they really need to deal with all of these experiences.

I believe that if this topic becomes ‘mentionable’, there will be a true path to happiness in motherhood as we all know that life experiences that can be shared are the ones that bring us the most joy!

What do you think needs to change for 'taboo topics' in women's health to become normalized and how does your work address that need? 

This is a complex question as I feel like the fact that there are taboo topics in women’s mental health at all is a reflection of a social justice issue — women’s inequality around the world. So, it’s a systemic issue of oppression of women and that will take many coordinated efforts at a macro level to change.

However, here in the United States, one system that I believe reproductive mental health experts can impact is our healthcare system. As things stand now, statistically, most perinatal women will never meet me or a psychotherapist like me, but will almost certainly interact with doctors and nurses during pregnancy, delivery, or post-partum.

I am a part of several advocacy groups looking to change the stigma surrounding taking medications for depression or anxiety during pregnancy and lactation and at the Family Institute we are working to network with OB-GYNs, midwives, doulas, etc. so that a referral to psychotherapy becomes part of routine, preventive care vs. something that you need to do because ‘something has gone wrong’.

I believe if healthcare professionals have easy access to referrals for therapy and talking about taking care of your emotional health becomes part of routine prenatal care, we can start to unravel the taboo nature of mental health issues in the transition to motherhood.

 This article was originally published on 12/22/12 as part of a longer piece titled "Postpartum Q&A with Emotionally-Focused Couples Therapist Nikki Lively"

Read more of our conversation with Nikki Lively: 

Is This Postpartum Depression? with Therapist Nikki Lively

When we started Nyssa, one of the first connections we made was with a wonderful therapist, Nikki Lively, who later joined our Board of Advisors.

As Clinical Director of the Transitions to Parenthood program at the Family Institute of Northwestern University in Chicago, IL, Nikki is particularly passionate about supporting people throughout the matrescence/patrescene journey.