I just finished reading The Postpartum Husband, by Karen Kleinman.* This is hands down the most fabulous book I have seen for partners (except for the non-PC title that excludes same sex or unmarried partners) supporting women through Postpartum Depression. It is basically the Men are from Mars Women are from Venus of Postpartum Depression Recovery sourcebook. The style is direct, informative, non-shaming and concise. The chapters are 1-2 pages long- perfect for men and partners wanting bullet point versions of information that are most likely sleep-deprived and potentially in-crisis-with-a-depressed-new-mom-and-baby. Some gems that stood out for me were: YOU CANNOT FIX THIS.
What works for you may not work for her:
You’d want to be alone; she wants you there all the time
You’d get up and out and run yourself through this; she stays inside and can’t get up and go
You’d isolate yourself at work; she craves support and comfort from others
You’d turn your sadness into anger; she feels inadequate and worthless.
As a pragmatic clinician and eating disorder specialist, I am always asking the question, how does this apply to eating disorder recovery? Here are Karen Kleinman’s thoughts on supporting women in PPD recovery followed by my thoughts on supporting women in eating disorder recovery:
- The single most important thing for you to do to help is to sit with her. Just be with her. No TV, no kids, no bills, no newspaper. Just you and her. Let her know that you are there. (DITTO)
- This isn’t easy to do, especially with someone who seems so sad or so distant. Five minutes a day is a good place to start. (DITTO)
Here’s what you’re up against:
- If you tell her you love her, she won’t believe you (Ditto)
- If you tell her she’s a good mother, think you’re just saying that to make her feel better. (Substitute “good person.”)
- If you tell her she’s beautiful, she’ll assume you’re lying. (Ditto. If you tell her “you’re not fat,” she will think you are lying or are minimizing her distress.)
- If you tell her not to worry about anything, she’ll think you have no idea how bad she’s feeling.(Ditto)
- If you tell her you’ll come home early to help her, she’ll feel guilty. (If you tell her you will eat with her to help her, she will feel guilty, ashamed, anxious)
- If you tell her you have to work late, she’ll think you don’t care. (If you tell her you have to work late, she will think it is to be with someone else because you hate her company or are sick of her.)
You may (as the partner) be thinking, THEN WHAT IS THE POINT? Anything I do is fruitless. That is where I would encourage you to be aware of the cognitive distortions rampant in depression and eating disorders that you are up against: all or nothing thinking, personalizing, perfectionism, minimizing, control fallacies… However, there ARE things you can do. Here are some examples:
- Tell her you know she feels terrible. (Ditto)
- Tell her she will get better. (Ditto)
- Tell her she is doing the right things (therapy, medication) to get better. (Ditto)
- Tell her she can still be a good mother and feel terrible. (Substitute “person.”)
- Tell her it’s ok to make mistakes she doesn’t have to do everything perfectly. (Ditto)
- Tell her you know how hard she is working right now. (Ditto)
- Tell her to let you know what she needs you to do to help. (Ditto)
- Tell her you love her. (Ditto)
- Tell her your baby will be fine. (Tell her that her eating disorder is not destroying you and that you can handle all of her feelings.)
For eating disorder recovery, I would add the following DO’s and DON’t’s:
- Do NOT try to be “the food police” or try to be her nutritionist/dietician. DO redirect her to her nutritionist/dietician for advice on her food plan recovery.
- Do NOT bring up emotionally difficult conversations during meals when she is already struggling. DO know that meals will most likely be uncomfortable for her and keeping conversation “light and polite” or simply giving her a kind look that acknowledges you know meals can be tough for her, but you are right here beside her. DO ask when a good time to talk about difficult things is for her and for you (ex in the morning, at night before 8pm, on the weekend).
- Do NOT assume she is feeling or will feel better if she is eating according to her food plan, gaining/losing weight as a result of her recovery action steps. Do NOT comment on her body size, even if you think she looks “better” or “healthy.” . She is most likely feeling WORSE. DO validate that she is most likely feeling worse and know that she will cultivate tools for managing these distressing emotions without using her eating disorder behaviors as she continues her recovery (therapy, group, nutrition) work.
- Do NOT comment on her appearance or “level of fatness,” even if she asks (ex “Do I look fat in this?”) DO instead say “How can I support you through this difficult feeling right now?,” “I trust your ability to find the right outfit that feels comfortable to you,” or “I’m not going to comment on that but love you.”
- DO access your own support system or if you don’t have one, develop one! CODA and Al-anon are great 12 step resources for partners.
For women recovering from eating disorders/body image difficulties AND postpartum depression:
DO remind her that you love HER and that her body made a baby. Remind her that postpartum media images are NOT realistic. Remind her she is a whole person that you love, not simply a body. Remind her that you are with her as a partner and friend with all of your own age-ing postpartum imperfections.
Above all, try to hold a big picture of this time as limited and it will get better. Take very good care of yourself and put your own oxygen mask on first.
As always, this blog is not intended to diagnose or treat any mental illness or eating disorder. Please contact your therapist for individualized diagnosis and treatment. If you would like to schedule an assessment with Dr Linda, you can call 415-335-2596
* Kelinman, Karen, MSW (2001) The Postpartum Husband: Practical Solutions for Living with Postpartum Depression
http://www.postpartumdads.org/ is a support resource for Dads run by Postpartum International.