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Postpartum Depression: Diagnosis and Treatment
Postpartum Depression: Diagnosis and Treatment

Section 3
Transition to Fatherhood

CEU Question 3 | CEU Test | Table of Contents | Depression
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In the last section, we discussed when a woman becomes a mother.  This included a feeling of suffocation, everything revolving around the baby, making motherhood the only source of fulfillment and misunderstanding the new father’s experience.

Do you have a client who is about to become a father? 

In this section, we will discuss when a man becomes a father.  This will include mixed feelings, misunderstood reactions, the "easing the father’s fears" technique and a father’s two roles.  As you listen, think of your client.  What are his fears and how does he cope?

A woman has the advantage of a progressive preparation for motherhood over the course of nine months.  She carries the child not only in her body, but also in her heart and in her mind.  Once the baby is born, she and the baby benefit from an extremely intimate relationship.  The father-child relationship, however, is external and more abstract.  He is usually less informed than the mother, rarely participates in initial baby care in the hospital, and does not often discuss baby issues with his friends and colleagues. 

Once home from the hospital, the baby and the baby’s supplies may seem to take over the house.  The father may be expected to stand close to the mother-child unit, but cannot enter into it.  He may also be expected to instinctively take over all the housekeeping chores and to have a sudden and burning desire to change diapers and give the baby its bath.  It is hardly surprising when the father feels left out.

3 Effects of Becoming a Father

♦ #1 Mixed Feelings
First, in spite of his joy, a father can experience many mixed feelings about a new baby.  He may feel threatened, now that all important decisions seem to be considered in terms of their impact on the baby.  Older fathers may be especially worried that the baby will cramp their lifestyle

The father may be jealous of the woman’s reproductive powers, which seem to bring her happiness and attention.  He may feel a strong burden of responsibility, as well as stronger professional and financial pressures to succeed, and thus provide adequately for his child.  While this may make him feel important, it may also be a huge source of worry.

The father may feel overwhelmed by his spouse’s emotional dependence on him, especially if the new mother is having difficulty recovering from the psychological aspects of pregnancy and childbirth.  He may be frustrated to find that his spouse appears to be perpetually engrossed in the baby and makes no time for him alone.  This reinforces his impression that he is no longer important to her.  He may be alarmed by the baby’s fragile appearance and not dare to touch it. 

♦ #2 Misunderstood Reactions
Second, the father’s feelings may lead him to react in ways that are easily misunderstood.  The father may seek refuge in his work.  This may be a way of forgetting his problems by remaining in a world where he still has some control and feels at ease.  It may also be a way for him to procreate or give birth to something himself.  If the father feels excluded from the mother-child relationship at home, he may find comfort in his relationships with his professional colleagues.

He may lack interest in the baby and avoid caring for him or her, at least not in front of the mother.  Often, if the father is alone with the baby, certain that no one is watching him, he may relax and interact with it.  Even if a father has not read and prepared for the baby’s birth, he is perfectly able to care for a baby’s basic needs.  And if he does not put the diaper on in quite the perfect way, it is not vitally important for the baby’s well-being.  The baby quickly becomes accustomed to the fact that every person has a different way of looking after him or her.

The father may want to take charge of everything, as if he did not trust the mother’s ability to care for the baby.  This situation may occur in second marriages when the man already has older children but the woman is experiencing motherhood for the first time.  Or it may be the man’s way of expressing his frustration at the woman’s lack of confidence in her own mothering abilities.

The father’s sexual desire for his spouse may greatly diminish or disappear.  This happens to many men during their wives’ pregnancies.  They are afraid of hurting the fetus, feel slightly offended by the physical changes in their wives’ bodies, or are afraid of not satisfying the woman, whose sexual appetite increases during the second trimester of pregnancy.  When the baby is born, they may have trouble accepting that their spouse is now both a mother and a sexual partner.  Sometimes, new fathers actually make greater sexual demands, also as a way of reclaiming their partner.

Roland, age 33, described to me how his marital relationship was affected by his wife, April’s postpartum anxiety.  Roland stated, "After the baby came, I had to go back to work after taking one week off to be at home.  I was feeling this incredible sense of responsibility and felt unprepared to be a father!  When April started having panic attacks when left alone, I was very angry at her.  I thought she was being unreasonable.  I felt betrayed by her, like she was leaving me with all the responsibility of the baby, her health, and I had to earn a living!  We fought the whole weekend before I was to go back to work!  On Sunday, she told me she wanted to kill herself.  That scared me so much that I called the obstetrician, who told me about postpartum.  I was shocked.  I didn’t know this could happen."

Most of the time, I have found that reactions like Roland’s are not signs of a permanent rejection, but are an indication of the man’s difficulty in adapting to his new role as a father.  Bitterness and recrimination from the mother sets into motion a vicious circle of anger and escapism. 

♦ Technique: Easing the Father’s Fears
I suggested to Roland and April that they try the "Easing the Father’s Fears" Technique.  I have found that a few simple gestures can ease the tension and show the father that there is room for everyone.  A few gestures that I suggested to Roland and April included trying to talk about something other than the baby, agreeing to go out once in a while without the baby and planning a weekend getaway in the future.

♦ #3 A Father’s Two Roles
Third, in addition to mixed feelings and misunderstood reactions, a father has two roles to play which go far beyond the family’s material needs.  First, he must provide a symbolic separation between the child and its mother.  As a child grows, one of the mother’s responsibilities is to teach him or her to become independent.  This task may be made much easier if the father plays his role.  The father may challenge the baby, often providing stronger sensations and emotion through the way in which he plays and communicates.

Second, the father can provide a source of affection, support, and recognition for the mother.  Although it is sometimes difficult for a man to accept that his spouse is feeling vulnerable and overwhelmed, he can do more to help and comfort her than anyone else can.  He can provide an objective "outsider’s" perspective and cut through many of her worries to find a solution.

Do you have a Roland?  Might he benefit from hearing this section? 

In this section, we have discussed when a man becomes a father.  This has included mixed feelings, misunderstood reactions, the "easing the father’s fears" technique and a father’s two roles.  Would playing this section be beneficial during you next session with a client you are currently treating?

In the next section, we will discuss marital disharmony, violence and depression.  This will include increased irritability, physical abuse and a lessened sense of self.

Peer-Reviewed Journal Article References:
Bouchard, G. (2012). Intergenerational transmission and transition to fatherhood: A mediated-moderation model of paternal engagement. Journal of Family Psychology, 26(5), 747–755. 

Kings, C. A., Knight, T., Ryan, D., & Macdonald, J. A. (2017). The “sensory deprivation tank”: An interpretative phenomenological analysis of men’s expectations of first-time fatherhood. Psychology of Men & Masculinity, 18(2), 112–122. 

Singley, D. B., & Edwards, L. M. (2015). Men’s perinatal mental health in the transition to fatherhood. Professional Psychology: Research and Practice, 46(5), 309–316. 

Troilo, J. (2017). Stay tuned: Portrayals of fatherhood to come. Psychology of Popular Media Culture, 6(1), 82–94.

Online Continuing Education QUESTION 3
What are some examples of misunderstood reactions that new fathers often have? To select and enter your answer go to CEU Test.

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