Holding not just one, or two, but three babies in mind!

Have you ever had that warm fuzzy feeling when an old friend remembers your birthday (and they aren't even on social media!), or weeks after a conversation about an injury you had, your colleague asks how your back is?

Being 'held in mind'

You get that warm fuzzy feeling because you feel valued - you have been 'held' in the mind of another person and you feel cared for. We need this feeling in our relationships, and not just as adults, but from the very moment we are born. Being 'held in mind' is fundamental to a healthy relationship and a secure attachment, where we feel comfortable depending on others and confident that our needs will be met if we ask.

When a mother gives birth to her baby, she experiences a pull away from the 'external world' and into a world of 'maternal pre-occupation' in which her only role is to hold the baby in mind; the baby becomes the centre of her universe. She may give up other identity roles (partner/friend/sister/colleague) in life to fulfil this all-encompassing role; the mother and baby merge into one as the baby has no concept of being separate from its mother. This is by no means an easy process and may be complicated by our own history and traumas.

Mothers of multiples

In recent years, there has been growing awareness and dialogue of postnatal mental health difficulties. One subsection of women who may have a particular set of struggles are parents of multiples. Here I speak about twins, but am holding in mind the parents of other multiples too. When a mother gives birth to twins, she not only has to hold one baby, but two, in mind. Her maternal pre-occupation, which is an evolutionary necessity for survival, requires that she considers the needs, desires, and emotions of two babies who are at the same developmental stage. Add to this the need to develop a relationship with each twin individually, to respect their own developing relationship, to find time to nurture the relationship with her partner or other children (if she has) and to nurture her relationship with herself; she will often be last on the list. However, she needs to be first on the list; becoming a mother often means experiencing emotions related to our own baby/childhood that she may need support with. She needs to be supported so she can support; she needs to hold herself in mind and be held in mind by those around her.

The psychological enormity of the task above is compounded by practicalities - how does she feed two babies at once with two breasts/bottles and one pair of hands? What will she do if she's out and both are crying? How does she fit the double buggy through most doorways? How will she attend a baby group and get both babies on the playmat which is far away from the buggy - meaning she has to leave one alone briefly - will other mum's judge her? And, finally, how will she actually make friends at the group? This would involve holding yet another mind in her mind whilst managing the two babies with her one pair of hands.

Mental health difficulties become a significant risk for mothers of multiples:

'Approximately one in five mothers of twins and triplets are diagnosed by their health professional as suffering from postnatal depression' (page two in booklet 'Postnatal Depression: A Guide for Mothers of Multiples' by TAMBA).

With a growing recognition of women carrying the 'mental load' in the household, and society's reluctance to accept the 'shadow' of the mother (the idea that sometimes a mother may hate and have aggressive feelings towards her child for example), it is not surprising that mothers, especially those of multiples, may end up feeling isolated and alone with stress levels rising. Shame in speaking out may be exacerbated by having gone through the IVF process and feeling like she should be enjoying motherhood after all she has gone through to have the children she wanted.

Support

So, we need to help mothers by highlighting the process of transformation to motherhood as a complex one. With this might come clinical depression or anxiety, but it may not. We need to be careful of the risk of pathologising and overlooking the mother's holistic experience. The transition to motherhood is a fundamental change of identity and maturation, which will affect each individual differently dependant on character, history, current support, and circumstances. 

Therapy can be a safe and confidential space for mothers to explore this transformation, where there is boundaried time set aside for the mother being 'held in the mind' of another. A mother can hopefully start to see the value of looking after herself, of accepting her emotions rather than feeling ashamed of them, of seeking support from others and asking for help which will, in turn, support her to be a 'good enough' mother to her children.

Another invaluable resource to tackle isolation is connecting with others in a similar situation. TAMBA (Twin & Multiple Births Association) has a website with a wealth of information, including a telephone support line and twin/ multiple groups that run in many parts of the country where parents of multiples can meet other parents.

Often, if we share our vulnerabilities with another trusting other we feel less isolated and alone which is especially important for parents of multiples. So, if you are a mother of multiples and struggling, know that you are not alone and try to speak with someone you trust, visit a local twin group, seek therapy options through your GP for local free services or privately with a qualified therapist.