The Transition to Motherhood for Therapists
Examining and Reflecting on Issues of Gender and Identity
Psychotherapy Bulletin Editor’s Note: Given that many women who become mothers do so during the early years of their training and practice, it seems relevant to address this topic through an Early Career lens. It is important to recognize that gender discrimination impacts women of all ages and at every career stage, and that women may become mothers or be impacted by many of the issues discussed in this article at a variety of points before, during, or after their professional careers. By no means is the framing of this article meant to imply that the issues of gender and identity raised by motherhood and clinical practice are exclusive to early career professionals.
As Mother’s Day approached this year, I found myself reflecting on my experiences the previous May. It was a watershed year for me, both professionally and personally, as I navigated the challenges of a postdoctoral residency in child community mental health while learning to parent. Last year, I was midway through my residency and deeply involved in both my relationships with my son and with my other “children”—the clients with whom I spent much of my time.
I vividly remember the strange experience of my divided mind that day. I celebrated my new role with my family, but found myself wondering about my clients, several of whom had been separated from their biological mothers at some point. I felt guilty and grateful at the same time, and wondered how my clients were doing on this triggering day. This experience was one of many similar during my training year, a year of learning to integrate my identity of mother and therapist.
About two-thirds of all practicing psychologists in the United States identify as female (American Psychological Association; APA, 2015). Over half of these psychologists are under the age of 50, and many are, or will become, mothers at some point during their careers, often during the early career phase.
Although the field of psychology includes many mothers (and potential mothers), discrimination continues to impact female-identified trainees and therapists, despite efforts to enhance cultural competence in this area (Bertsch et al., 2014). In the workplace, female therapists may encounter gender-related events (GREs), defined by Walker, Ladany, and Pate-Carolan (2007) as relational experiences that are influenced by one’s sex, gender, or social stereotypes related to gender roles.
However, to date there has been little scholarly research on new-mother therapists (Waldman, 2003). In this paper, I discuss how gender discrimination and bias affect new mothers, explore the ways that identity may shift during this transition, and reflect on my own experience of becoming a mother-therapist.
New Motherhood: Issues of Bias and Discrimination
Gender discrimination and bias toward new mothers has been well documented and continues to be a major social concern (Benard & Correll, 2010; Cech & Blair-Loy, 2014; Correll, Benard, & Paik, 2007; Stone & Hernandez, 2013; Williams, Blair-Loy, & Berdahl, 2013). Mothers are seen as less competent, less trustworthy, and less committed to their jobs than their non-parent peers and fathers, which results in wage discrimination by employers (Benard & Correll, 2010; Correll & Benard, & Paik, 2007; Williams, Blair-Loy, & Berdahl, 2013). New mothers are driven out of the workforce by lack of support, hostile work environment, and perceived or experienced stigma (Benard & Correll, 2010; Stone & Hernandez, 2013; Williams, Blair-Loy, & Berdahl, 2013).
GREs experienced by new mothers might include discrimination at work (e.g., fewer referrals upon return from leave or lack of private spaces for pumping), negative responses from supervisors or colleagues (e.g., negative statements about needing to leave work early due to child’s illness or being passed up for promotion), and, for mother-therapists, challenging interactions with clients (Baum, 2010; Dyson & King, 2008; Fallon & Brabender, 2003; Hamilton, 2013; Raphael-Leff, 2004; Shaw & Breckenridge, 2014; Waldman, 2003). For therapists with children, discrimination and bias in the workplace, if not appropriately processed and addressed, can negatively impact collegial relationships, trust for supervisors and employers, and work with clients (Bertsch et al., 2014). Because new mothers’ experiences are often minimized, it is also important to explore the impact on women’s gender identity and roles (Prinds, Hvidt, Mogensen, & Buus, 2014).
The Great Identity Shift
Many have described the transition to motherhood as one of the most impactful experiences in their lives, shifting their perspectives and identities in profound ways (Baum, 2010; Dyson & King, 2008; Hamilton, 2013; Laney, Hall, Anderson & Willingham, 2015; Raphael-Leff, 2004; Shaw & Breckenridge, 2014; Waldman, 2003). New mothers tend to experience a time of great personal growth, as well as an opportunity for integration of new values and meaning. The transition to new motherhood may radically alter the ways women experience their bodies, their relationships with others and themselves, and their sense of personal meaning and spiritual beliefs (Prinds et al., 2014).
While this shift in identity can bring opportunity for personal growth, it may also complicate or even disrupt women’s professional identities and career aspirations. Studies have found professional women are sensitive to negative messages in the workplace, particularly around their competence and their emerging need for flexible scheduling and family leave (e.g., sick days; Stone & Hernandez, 2013; Williams, Blair-Loy, & Berdahl, 2013). Professional women are more likely to opt out of returning to work, feel less satisfied with their jobs, and are less likely to persist in their career when they face stigma and discrimination at work (Benard & Correll, 2010; Cech & Blair-Loy, 2014; Stone & Hernandez, 2013).
Women tend to feel pulled between the dual roles of mother and professional, and this constant struggle can reduce their ability to engage in executive functioning tasks (Hodges & Park, 2013). It is clear that new mothers face many challenges in the workforce, but becoming a mother may present therapists with an opportunity to enhance their clinical skills in profound ways, while also enhancing their identities as mothers.
Clinical Work as a Mother-Therapist
The process of developing this new identity offers enormous opportunity for growth, especially for therapists. The experience of attuning to, mirroring, and creating a holding environment for their children, hallmarks of a “good-enough” mother (Winnicott, 1971), can be applied by mother-therapists to their work with clients, which can facilitate therapeutic change (Kenny, 2014). Mother-therapists have reported they feel their new identity and experience helps them better empathize with their clients, to understand developmental issues and needs, and to utilize primitive affect and intuition in their clinical work (Fallon & Brabender, 2003; Shaw & Breckenridge, 2014; Waldman, 2003).
Therapists who choose to disclose their status as a mother to clients who also have children may be perceived as more empathic and understanding of their unique life experiences, which may, in turn, positively impact the therapeutic relationship and treatment outcomes (Hodges, Kiel, Kramer, Veach, & Villanueva, 2010). Waldman (2003) notes the transition to new motherhood allows for an expansion in the transferential relationship between client and therapist, including an ability to intuit unspoken or preverbal issues that may cause “stuckness” for clients.
Additionally, clinicians who are mothers report they are able to use their experiences in clinical work to benefit their relationships with children and partners at home (Shaw & Breckenridge, 2014; Waldman, 2003; Zur, 1994). For instance, professionals working with abused children were found to display more democratic parenting practices (Dursun, Sener, Esin, Anci, & Sapmaz, 2014) and child welfare workers utilized reflection and meaning making to enhance relationships with their children (Menashe, Possick, & Buchbinder, 2014).
On the other hand, there are clinical challenges accompanying the territory. New mother therapists may find they are, in fact, too open to clients’ emotional and nonverbal experiences, which may result in a decline in objectivity (Raphael-Leff, 2004; Schmidt, Fiorini, & Ramires, 2015; Waldman, 2003). Therapists may experience diffuse boundaries, a tendency to over-identify with clients, and difficulty drawing appropriate limits during this time (i.e., going over session time or responding to out of session contacts).
They may be more likely to engage in rescue fantasies, especially when working with children and families (Malawista, 2004; Raphael-Leff, 2004). They may find that the needs of their child leave them with less space and patience for those of clients (Raphael-Leff, 2004; Shaw & Breckenridge, 2014; Waldman, 2003). Mother-therapists can find themselves so burnt out by the emotional and physical needs required in both roles that they have little time or energy to care for their other relationships and attend to their own needs (Waldman, 2003).
Acknowledging Issues of New Motherhood: Cultural Competence Within the Field
It is clear that exploration of issues facing new mothers benefits the field of psychology on levels both systemic (e.g., ensuring psychologists are able to continue working in the field after becoming parents) and personal (e.g., allowing therapists to process and make meaning of critical events related to parenting status). The APA’s guidelines for work with women and girls (2007) state that psychologists who work with women and girls should help their clients “understand the impact of bias and discrimination so they can better overcome the impact of obstacles that are external in origin as well as internal” (p. 963). In order to effectively explore these issues with clients, psychologists must first recognize and acknowledge their own experiences of gender socialization, discrimination, and bias, as well as how they understand these events (APA, 2007).
Agencies and organizations can promote well being and encourage cultural competence by facilitating thoughtful conversation and training about these issues. New mother-therapists report that the ability to engage in honest, open dialogue about their experiences allows them to make meaning of this transition, and to feel less conflicted in their parenting-career roles (Baum, 2010; Fallon & Brabender, 2003; Hamilton, 2013; Raphael-Leff, 2004; Shaw & Breckendridge, 2014; Waldman, 2003). Supervision, peer consultation, and mentoring with other mothers may be particularly helpful, and allow women to feel safe disclosing their experiences.
Supervisors of new mothers should be aware of the immense shifts in identity discussed above, and should be willing to openly process gender-related experiences and challenges supervisees bring in (Bertsch et al., 2014; Walker, Ladany, & Pate-Carolan, 2007). Open and honest exploration of such issues helps therapists feel competent, supported, and satisfied with work (Bertsch et al., 2014). This is important since therapists who feel positively about their workplace are less likely to experience burnout and compassion fatigue (Thompson, Amatea, & Thompson, 2014).
Reflections on One Mother-Therapist’s Experience
Despite seeking out a residency with a family-friendly agency, I experienced many of the challenges described above. During the early days of my residency, I dealt mostly with logistical issues.
For example, I learned I needed to remind training personnel I would be taking breaks throughout the day during day-long trainings—and that I would need a private place to pump. Through experience, I realized I needed a childcare plan to ensure both clients, and my child, were cared for in case of a crisis at work. Tired and drained from both my new roles, I often felt like I was barely treading water.
Although my agency was highly responsive to feedback around challenges and accommodations, I soon realized it would fall on me to confidently and clearly communicate my needs. As the only new mother in my cohort, some things just were not “on the radar,” even though many staff members were new mothers.
Speaking directly about something as private as breast milk left me feeling exposed and uncomfortable. I often felt anxious and rude as I snuck out of trainings, but told myself firmly that I was doing what I needed to do as a parent. At times, my roles of trainee, mother, and therapist seemed directly in conflict with one another, and I struggled to balance them.
When the stress of the more practical challenges of new motherhood began to wane, I found the more existential and relational aspects of this transition ramped up for me. I began to settle into my relationship with my baby and my clients, and to notice shifts in myself. I often felt tender and vulnerable during sessions, especially when working with children who had experienced early relational trauma.
I found myself more tearful and emotionally responsive than before—during supervision, during consultation with colleagues, even during sessions at times. Much of my work involved home-based therapy, and I noticed myself struggling to parse out what was mine, what was theirs, and what was ours in these sessions. As I sat with my son, I sometimes thought about my desire to offer a “good-enough” experience to repair my clients’ early traumatic experiences.
These responses often provided valuable insight into my clients’ inner lives, but at other times I wondered whether it was normal to experience such intense emotions. In some group settings, I felt worried that talking about these experiences would make me seem less competent.
In order to cope, I found answers to my questions, solace, guidance, and support from my colleagues and supervisors who were also parents. I was lucky that almost all of the psychologists responsible for my training were mothers—and many of them had even had a young child during their own residency.
I found “allies” within my agency—from my training director, who ensured I had a private place to pump during trainings, to my supervisors, who helped facilitate my understanding of my own experiences as a mother and how they impacted my clinical work. I found the more I shared my story with others, the more I was able to integrate my new and old identities and feel secure in my dual roles.
Supervision was particularly important over the residency year. I frequently encountered therapeutic issues related to mothering, and my supervisors encouraged me to explore these. For instance, I was able to process the ways gender stereotypes about mothers contributed to my own anxieties and fears about being a “good-enough” mother while completing my emotionally intense residency.
I was later able to use this experience clinically as I worked with a mother who feared she was at fault for her child’s explosive behavior, due to her mental health struggles during his infancy. Through ongoing supervision with a team of culturally competent and humble psychologists, I began to feel competent when using my own experiences and openness to attune to my clients and help them feel empowered and heard.
Discrimination, bias, and stereotypes of mothers affect many in our field, but are rarely examined critically. Furthermore, discussing the major identity and role shifts that occur when becoming a mother may be discouraged or minimized, leading to dissatisfaction and burnout for mother therapists. Exploring these issues opens the door for us to examine nuances of gender and identity, how they may affect our views of ourselves, and how they may inform our work with clients—in the early stages of our careers and beyond.
Cite This Article
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Can you tell me the publication date of the article by Dr Maggie Benedict-Montgomery: ‘The Transition to Motherhood for Therapists’?
With many thanks from Naomi Stadlen