Heather Toum, M.Ed, LMHC
Intrusive thoughts are intense, unwanted thoughts or mental images typically related to harm of yourself or the baby. For a new mom, this is often a terrifying experience for multiple reasons. For one, you were probably not warned that this may happen and that it is a common occurrence. For two, you probably have no idea why it is happening, which provokes fear. This post will provide psychoeducation and tips for reducing the frequency and intensity of intrusive thoughts.
How Common is this?
Research suggests that 94% of people in the general population endorse having intrusive thoughts. The difference between these thoughts and those from a postpartum mom is that many of these thoughts are related to the baby. Common examples of intrusive thoughts or images may include:
Thinking or imagining drowning the baby
Dropping the baby
Seeing the baby dead
Imagining the baby suffocating or dying of S.I.D.S
Impulses to shake the baby
Postpartum women (or men) with intrusive thoughts often, but not always, present with other mental health symptoms such as depression or anxiety. Sometimes the distress of these thoughts will result in obsessive thinking, leading to repetitive behaviors (compulsions) to reduce the distress or anxiety. This pattern results in Obsessive-Compulsive Disorder (OCD), which occurs in about 11% a new moms (see PMADS: http://cpw.care/pmads/). OCD occurs twice as often in the postpartum population as it does in the general population. This means it is more likely for a mom to be highly distressed over these thoughts.
Why is this Happening?
The major reason why a person has intrusive thoughts is due to a survival mechanism in order to keep yourself alive. For moms, these intrusive thoughts are due to an innate necessity to keep your child safe. This may feel shocking to hear because these thoughts can be so terrifying and seem like the exact opposite! The fact that they are so terrifying means that the likelihood that you will act on them is extremely low (if not-zero-but no one can say for sure). In other words, intrusive thoughts are derived from the brain being wired to seek out possible harm to yourself or your baby.
3 Ways to Reduce the Frequency and Intensity of Intrusive Thoughts
Do Not Give Power to Your Thoughts. The number 1 most important thing you can do to reduce these thoughts, is to not give power to them. Recognize that although these thoughts can feel very intense and debilitating, they are still just thoughts. Just because you have the thought to jump off a bridge, does not mean that you will do it. The fear and other negative emotions created as a result of the thought, will only perpetuate more of these thoughts. However, if you recognize that these thoughts come in due to your brain’s wiring to seek out danger, and remind yourself that they are common, and that you will not actually act on them-they will start to feel less intense.
Recognize the Pattern. According the evidence-based cognitive-behavioral therapy model, the pattern is:
Something happens- For example: Mom is getting ready to go down the stairs while holding the baby
The intrusive thought occurs-Example: Imagining the baby falling or being thrown down the stairs
Mom has a negative emotion related to the thought-Example: Fear, shame for having the thought
Mom behaves based on this thought-Example: Gives baby to dad and avoids going down the stairs with the baby
Your therapist will help you recognize this pattern and help you identify alternate thoughts, resulting in a more neutral emotion. This will break the cycle of avoidance, which often occurs. The cognitive-behavioral model is effective treatment for many mental illnesses, including depression and anxiety.
3.) Seek Support. Often, postpartum moms with frequent intrusive thoughts will begin to internalize negative messages about themselves, such as “I am a bad mom” or “I am a monster”. Having a safe place to process these thoughts and associated feelings would be beneficial. It is also recommended to have a mental health professional, ideally someone trained in treating PMAD’s, properly assess your symptoms in order to rule out postpartum psychosis, which is charac
terized by delusions and hallucinations and is associated with suicide and infanticide, although luckily is a rare occurrence.
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