Harvard Book Store; WGBH Forum Network; Barbara Almond: The Hidden Side of Motherhood

So tonight we're here to celebrate the publication of Barber omens book The Monster Within the hidden side of motherhood. And I cannot think of a more appropriate person to introduce Dr. Amen this evening than her own son Steve Almond. Many of you may know Steve as he is one of Boston's favorite local authors. His mother has much to be proud of as he's the creator of countless articles reviews and books. Among his books my life and heavy metal the evil Bebe Chow candy freak and the rock n roll and rock n roll will save your life. He's also published not one not two but three books on how books are his own book making robot which I encourage you to check out the talk again everyone thanks so much for coming out tonight. Please join me now in welcoming Steve Almond. Hi is everybody comfortable or as comfortable as they can be and if not try to because we're going to go to about midnight my mom just parties and it's crazy. Yes the side. So all right I'm going to do a

formal introduction here of a woman for whom I literally could never have delivered this introduction without her help without whom Thank you mother. You wouldn't believe it that's the first time she's ever corrected me. So we're here to celebrate the monster within the hidden side of motherhood. And it's a book that my mom has been at work on in some sense since the day I was born. It's about women's fear of giving birth to monsters. She's also the author with her husband Richard Allman this little piece of arm candy right here ladies of the therapeutic narrative which is a remarkably incisive examination of how the most enduring fictional most enduring of our fictional relationships function as a form of therapy. And I have stolen from it often and generally an unattributed manner

when I want to sound area dight. Let's see. I'll say just to state the obvious that I wouldn't have become a writer without the support and before that the example of my parents who are my favorite sort of people on Earth which is to say their passionate readers. I love you both very much and feel very lucky just in the genetic lotto. That's who I got. Before you accuse me of bias a few other accounts of the book. This is from The New Yorker. The place where I have never been reviewed vampires incest babies and infanticides Oh my. Barbara almond spooky new book is just the thing for a gray and drizzly autumn afternoon drawing on her 37 years of practice as a psychoanalyst as well as her own experiences as a mother. Allman leads an adventurous tour through the shadowy secret parts of the mother's psyche Armand's theories are fascinating to read and Carolyn C. writing for The Washington Post had this to say. First let me recommend this engrossing study to every new mother

old mother good mother and bad mother. Husbands sons husbands dads and lovers might profit from reading this to the monster within addresses what everybody knows but almost nobody talks about. Even the best mothers among us will be or have been tormented from time to time by strong feelings of dread fear hatred and even revulsion at the whole process of motherhood as well as experiencing downright murderous feelings toward our children. That's true for I'm sure not my mother but I've heard from others and I'll just conclude with a little a visual aid that was handed to me. These are barbarous monsters in question. Forty two years ago. Yeah. So I'll hand this around and everybody can you know if you want to take a look afterwards if you buy a book. You can have. Please welcome Barbara Bowman. Well I'd like to start by saying that I never thought I would be here

or at any other bookstore or reading this book because I never thought it would get published. I was told over and over again that it's too disturbing a subject and probably 40 publishers later the university the University of California Press had mercy on me and decided to publish it. So I'd like to start by reading some segments from the book and then I think there will be not only a lot of questions but probably a lot of comments from the audience saying that it's about 90 percent women and that every one of you looks like a reader to me anyway. The title of the book I'm I'm often asked about that. The book really began as part of a paper that I had to produce in order to graduate from the San Francisco Psychoanalytic Institute and it was a book that was based on a woman who I saw in

analysis who was afraid to have a child and never did have a child. And it was really an eye opener for me in many ways. And she was afraid among other things that her child would be a creature or a monster. I was going to write a book about figures of monstrous infants in children in literature a book that probably would have sold about 25 copies if I'm ok. But based on what this book though we did together but this book slowly this this book began to morph into. A study of women's ambivalent feelings about their children. And that's really where it ended up. And so the the monster within therefore is not a fantasy of monstrous baby but women's feelings about their own mixed feelings about their children their fears that it's monstrous that they have

sometimes mixed feelings about you know about their young. So let me let me start. Think you can read this by reading something from from the preface to the book. This book developed from two primary sources. My own experiences struggles and anxieties as a mother and my clinical work with patients in psychotherapy and psychoanalysis over the course of 38 years of practice. Having gone through medical school thinking I would become a pediatrician I became a mother first. And once I was a mother I found it too disturbing to imagine taking care of ill and sometimes dying children. I decided to pursue instead further training in adult psychiatry and eventually to psychoanalysis.

The work I do with my patients whether psychotherapy or psychoanalysis is based on the premise that what you don't know CAN hurt you. Our personalities are deeply connected to our experiences in early life most of which we have forgotten. However these experiences in relationships live on in our unconscious minds. They're brought to life in the talking therapies during which they are relived hopefully between patient and therapist and subsequently understood. In my own work I treat patients people who do not need to be hospitalized but who suffer from neurotic problems and personality disorders. Often a mixture of both a neurotic neurotic disorders are characterized by symptoms in particular anxiety and depression and inhibitions in work love and creative endeavors related to unconscious feelings impulses fantasies thoughts and memories.

Much of the suffering of people with neurotic problems is internal. Neurotics tend to take out their misery on themselves. Personality disorders are somewhat more severe. People who suffer from them behave in characteristic maladaptive ways that cause much interpersonal difficulty in anguish. And I should say that neither of these things ever appears in pure form. Nevertheless people with such disorders also grapple with painful moods difficulty achieving goals and disordered relationships but they act them out behaviorally they do not suffer in silence. For most of my professional life I've treated more women than men. These women came to see me because of dissatisfaction depression and anxiety connected with their work and their intimate relationships. As I grew older my patient population aged. I saw more and more women with children

and some without children either by choice or failure to conceive. I began to tune in more to women's fears surrounding their reproductive activities pregnancy childbirth and most of all mothering. I believe my sensitivity to these issues increased as I got older and as my own children grew up I no longer had to deny out of anxiety shame and guilt. My own and maternal ambivalence and shortcomings. Furthermore it became increasingly clear to me that the shame and guilt that my ambivalence in gendered had made it extremely hard for me as a young mother to come to terms with my limits. And it's not so easy as an older mother either. But it was very very difficult at that time and I began to see that this was true for most mothers. In my situation I was deeply conflicted about how much time to devote to my mothering versus my profession. My children were born when I was in my mid 20s before I had completed my

psychiatric training. I feared if I waited too long to return I would lose confidence in my role as a professional. But there was a truth even harder to face. As much as I loved my children they were demanding and exhausting and my work although also demanding and exhausting was often a respite. I made an important compromise in arranging to do my residency part time taking five years to complete a three year training programme. For many years after I began my private practice I tailored it to the school schedule. Nevertheless when I was at work my children were often on my mind. The first day of my psychiatric residency was also the first day of nursery school for my two and a half year old son. Not this one. His older brother when I left him at school he was crying and by the time I got into my car I was in tears also. Unable to

concentrate on my work I called the head teacher at least three times that first morning. Finally she tactfully suggested that I have my husband bring him to school in the future. This this solve the immediate problem of my son's crying but not the chronic problem of my guilt and anxiety about my children and my mothering. During the mid 90s I happened to be treating all at once. Several women who were conflicted about whether or not to have children. Having wanted children myself as a much younger woman that I had not thought much about this issue. I assumed all women wanted children and if they were not aware of this therapy or analysis would put them in touch with this wish and if it was not too late lead to motherhood. As it turned out this is something was wrong. The fears and conflicts some women

feel about motherhood are so strong that treatment cannot tip the scales in favor of having children. I came to realize that all my female patients past and present had been or were at least part of the time dealing with guilt and shame about the quality of their mothering or their avoidance of motherhood. And this was true even if they were devoted and conscientious mothers. It gradually became clear to me that fears about adequate mothering span a spectrum in time beginning long before the prospective mother's decision about childbearing and extending throughout her life as both a mother and a daughter. These fears often manifest clinically in disguised forms such as rationalized deferments of pregnancy often until it is too late. Poorly understood abortions or indirect form difficulty smothering or difficult feelings about mothering. The first theme that

engaged me because it appeared in the treatment of several women during the same period concerned of the fear of burying or creating non-truths monstrous offspring. Thinking about this fear from a psychological point of view I began to speculate about the meaning of monsters and our fascination with them in literature and popular culture. This was in the first the first plan for the book. Every Halloween I can count on young Frankensteins and Dracula's appearing at my door along with ghosts witches bats black back Black Cats pirates other icons of horror. True princesses and fairies and butterflies and an assortment of other benign animals also appear but monstrous figures far outnumber them among the young supplicants who read who ring my doorbell hungry for sweets. Why Frankenstein and why Dracula. And why have the grim novels from which they sprang remain bestseller sellers for more than a hundred years.

They must speak to very basic human psychological issues. One of the reasons we read is to find out more about how others deal with the conflicts that consciously and unconsciously trouble us. To understand how their stories play out how they deal with closeness and distance love and hate damnation and redemption. As I reflected on the subject of monstrous offspring my thoughts gradually turn to a more general issue. Women's difficulties dealing with the negative side of maternal ambivalence through all the phases of child rearing. What I think of as the dark side of motherhood and as a result as the hidden side of motherhood the central subject of this work conflict is the bedrock of human psychology and has always manifested in some form of ambivalence. The word we use have feelings of both love and hate towards the same person. It's a goal or

desire in our lives. It is a completely normal phenomenon. What we love can disappoint us what we love we can also lose and what we lose causes us pain. That mothers have mixed feelings about their children should come as no surprise to anybody. But it is amazing how much of a taboo the negative side of ambivalence carries in our culture especially at this time. I believe that today's expectations for good mothering have become so hard to live with the standard so Draco nian that maternal ambivalence has increased and at the same time become more unacceptable to society as a whole. I feel very strongly that women suffer unduly from the anxiety and guilt that they are ambivalent. In genders in them and the disapproval that it in genders in others. Ambivalence needs to be understood as a phenomenon that can be both constructive and destructive constructive when it

leads the mother to think creatively about her difficulties mothering and they can be managed how they can be managed and destructive when it leads to hopelessness intractable guilt self-hatred shame anxiety and punitive behaviors. Now that's all of the preface that I'm I'm going to read at the moment. The book as a whole is made up of my own observations clinical observations and theories about the scope and results of maternal ambivalence. I use a lot of clinical examples disguised and generally in the past not of patients who I'm currently seeing the experiences of relatives friends strangers and occasionally myself even better disguised in the ones of the action. And the dramatic examples I feel dramatic examples from literature where authors may be able to say what patients often cannot say.

The shape of the book is to begin with explanations of ambivalence. Mother love fears of pregnancy and childbirth and then the spectrum of ambivalent feelings. Among them the too good mother who doesn't recognise her ambivalence at all. The ambivalent mother who internalizes her feelings and feels guilty and blames herself. And also women who externalized their ambivalence and blame their children and feel punished by even being mothers. And I'm going to read two brief passages one about the too good mother and one a little bit about a mother who internalizes just to give you a flavor of what I mean by these things. And then we can go on to have some questions and discussion. But before I do that I want to read a passage that has to do with what probably somewhere was

the beginning of this book a long long time ago and since I see in this audience some of my classmates from Yale Medical School. I wanted to talk about a study that I did during that time. Yale Medical School didn't feel it was enough for you to go through medical school Teevan and you have to write a final paper and it had to be a research paper like a mini thesis actually. So at those many years ago in my early 20s I had the opportunity to observe the passionate bonding between mother and child in the earliest days of life. As a medical student at Yale University I did a research thesis on social class differences in sources of information on infant care. In the course of this study I interviewed 20 first time mothers in their first few postpartum days. These were twenty mothers most of them about my age at that

time. Most of them were blissful and delighted. Happy to be through their childbirth and convinced that their babies were beautiful and special. But two were not. One of the unhappy women was a graduate student who had given birth to twins a boy and a girl. She knew in advance that she we she would be having twins. And when I interviewed her three days postpartum she was talking about the girl as my baby and the boy as my husband's baby. Overwhelmed and frightened at the prospect of caring for two children she didn't want to nurse the little boy. She was however quite distressed at these feelings and said quote emergency supportive psychotherapy which actually was the interview I did with her which went on for several hours. It apparently was very helpful to her because when I saw her a few days later she had decided that she didn't have to nurse both babies entirely. She

could supplement each of them with a bottle and she was already noticeably calmer and more attached to the little boy. Her husband's willingness to participate actively in infant care was also helpful to her in regaining her balance. This was a situation worth noting a potentially harmful degree of ambivalence was arrested by a combination of crisis intervention therapy and spousal support. I believe the brief quote therapy was helpful because her feelings were treated with respect and understanding rather than the condemnation she expected. The ensuing relief of her anxiety and guilt allowed her to solve her dilemma with practical measures that were previously unacceptable to her. Sharing the nursing between the two babies and using supplementary bottles and such and such. I did not get a chance to follow up her situation but it wouldn't surprise me if she became gradually able to nurse both babies fully and if she didn't it didn't matter at that point.

Her confidence in her motherhood was not derailed at this crucial early time. The second situation in this is 2 out of 20. The other 18 no problem. That situation seemed much more ominous. The mother an 18 year old married woman was so upset and anxious I could barely interview her and she barely would agree to an interview. What her sources of information on infant care were seemed highly irrelevant. She wanted nothing to do with the baby. He frightened her. She talked of the difficult birth and implied that he would be very hard to take care of. He was peacefully asleep during the entire interview. I found myself feeling very alarmed. It was clear that this woman's mother in large extended family would in effect care for the child. The study did not involve later follow up but in retrospect thinking about it and in current years I realized I was

witnessing the development of a monster baby in the mind of the mother. And unlike the mother of twins this woman had no interest in psychotherapeutic intervention. She wanted out of the situation she found intolerable. And I don't know why. I just knew that that was the way she felt. I should add that there didn't seem to be any relationship between reported difficulty of childbirth and enthusiasm for the infant in the other 19 women. This patient was disturbed and unprepared for motherhood in any form. So you could say that things sort of started there in a way. The next thing I wanted to do it. Well I don't know that I have that much time. Maybe I'll just read this one. This one vignette and then we can we can go on to questions discussion opinions.

This is in a chapter called The subtle ambivalence of the too good mother. This is the story of Tanya. The daughter of a friend of an acquaintance of mine and it's one that's typical of two good mothers of a certain type. These mothers are convinced that doing the right thing were protect their children from all sorts of future emotional behavioral and learning difficulties. This belief in the right thing can be a rationalization for a kind of fanaticism that is often deeply rooted in their early experiences. Now in time is case these experiences involved having been raised in a family of religious fundamentalists in her family. If one believes something this alone made it right. I'm comparing their way of looking at the world with a more imperial and scientific view. That is if something is proven right. It is then believable as an adult. Tanya was close to her family but distanced yourself from their religious

fundamentalism and political conservatism. But as so often happens this discarded fanaticism appeared in a different form. Tanya became an atheist politically left wing and it didn't leave her in alternative medicine and child rearing practices. These convictions and practices were right because she believed in them. OK now at risk of offending some of you I'll give you something of a description of her. Her three children were home birthed. This is not a problem with the second and third children but Tanya's first delivery was a nightmare. The second stage of labor was protracted and extremely painful. Ending up in an emergency trip to the hospital. There Reluctantly she accepted inept epidural and delivered the child within the next hour. Tanya viewed this birth as a failure on her part. Although she loved her son dearly her childbirth wasn't natural now.

Her later success at home delivery with the easier labor she had with her two smaller daughters alleviated her guilt about her son's birth. But why should she have felt guilty in the first place. Tanya nursed all her children in an equally fanatical way. It was only her exhaustion from long sleepless nights and her need to get out and see friends once in a while that induced her to permit her husband to give the babies an occasional bottle of pumped breast milk. If they hadn't it is not clear when or if Tanya would have weaned them. She did not believe in vaccination or other forms of modern medicine except in dire situations. Her children were not given painkillers or antibiotics. Their food was 100 percent organic and mostly vegetarian. Sugar was carefully proscribed. Tiny's husband went along with his wife's convictions when it came to child rearing. But he was more relaxed about the entire project and as a result he seldom intervened. The

tiniest sense of rightness went beyond the physical care of her children. The family did not have a television set and until they were older the children were allowed very limited time on the computer. Tanya believed that scream time interferes with brain development and it well may. But you know toys were made of wood never plastic and had to be educational as well as fun. The family lived in a city with good public schools. Tanya did not push her children about their school performance which was fortunate because her son had a lot of trouble with his verbal skills to several years. He especially minded the absence of computer time and he later turned out to be a natural at computer work. Both her children were daughters did well at school and were generally more compliant with the rules of the home. Now one could ask where the hidden ambivalence was in Tanya's maternal behavior. Most mothers worry about doing the right thing and tend to fall of the class related popular cultural practices of their time and time it was certainly an

involved and loving mother. But she pushed her beliefs too far. She was subtly inflexible. A story she told me illustrates this in flexibility. Because her first child weaned himself once he began to eat solids. She was worried that her nursing had been inadequate. It was especially important to her that she nursed her second child adequately. This little girl was a frequent and lusty feeder and it was hard for Tanya to keep up with her especially now that she had two children. One afternoon when Tanya was just exhausted her mother urged her to try giving a baby some rice cereal. Reluctantly Tanya agreed. The baby then seven months old ate it avidly. Tanya began giving her solids regularly but again felt she was a failure as a mother because no food is the equivalent of mother's milk. But Tanya did exhibit exhibit a particular kind of end of line behavior that was striking because it was so different from her usual concern about her children's welfare.

She would make dates with friends or planned short vacations without adequately preparing the children for her absence. She would then let them know she she would let them know she would be gone but often she did not give them enough time to take her absences in and she was not entirely reliable about when she returned. Since her children were all deeply dependent on her it was very destabilizing. As the children grew older they had trouble with separation broke from both from their parents and from each other. I believe time has erratic behavior with regard to separations revealed her unconscious ambivalence as well as her unconscious worry about harming her children. The harm was projected into the wrong foods the wrong practices and the wrong toys all of which she avoided and could control. But it surfaced in her mistakes surrounding separation of these mistakes fueled by ambivalence. She was unaware.

I'm sure some of it could repeat the question. OK the two the two post-partum babies whose mothers were having trouble with them. This woman would like to know how much of that was attributable to hormones and chemical changes. Well I don't know for sure I mean some of it well might have been but then what do you do about the others who I'm sure went through baby blues you know when you when you interview someone the second day in the hospital you may catch them before some of that depression that comes when you when you go home but this went way beyond that especially the last woman that I described. I just don't think she was ready and I don't know what the circumstances were under under which she got pregnant which might have had something to do with it but that wasn't part of the study. The question was Is there any relationship between this study and Adrian Rich's work in her book of woman born. There certainly is and I quote her and I

read that book I remember reading it when my children were much much younger and I thought oh my god. I'm not the only one. It's very very striking. There are several vignettes in there and some larger parts of the book that refer to me in disguise form. OK and I'm not going to tell you what they are. Yeah. They have to be able to stand on their own feet. You know they they won't be unfamiliar to you when you know when and if as it were. The people I see and the people I associate with are largely middle class educated people and so that's my sample. I mean I'm aware that for instance among working class women some of the forms that ambivalence takes certain kinds of laziness not being careful about diet and some of these are economically you know

using television as babysitters not to say that this doesn't happen to middle class women. Corporal punishment at times I mean there was a time when you know when I grew up you got spanked if you were naughty but I mean that's that's a no no now. But I do acknowledge in talking briefly about these women that this is really more hese hearsay and not not something I'm familiar with. I mean I got interested in this whole subject through my work with this patient. And you know it just it just went on from there and I wasn't about to write about something I don't know about. Lower class women working class women don't have the luxury of feeling terrible about going to work because their kids are going to die if they don't. You know so it's a whole whole different kind of situation. It's not just it's not a self-help book but I hope it's helpful. You know I think I think it's meant to be

reassuring. The last chapter deals with you know what you can do. And the point I make is that therapy and analysis may be very very helpful particularly if problems are fairly severe but that women need to talk to each other about these things more honestly and and they don't. I actually quote a member of this audience in my book and I'm not going to say who she is who told me in on reading I think the first chapter that her mother's group had once taken up the whole subject of negative feelings towards their children and been quite forthcoming about it. And then all felt so ashamed they could never go back to it again. And this is not good. I don't think anyway. I don't think the Simonis movement. Brought to bear these kinds of standards and rules and what's good and what's bad. I think the whole point of

that was that when they felt women could both work and raise children and there was no reason to not do both. And as it turns out it's very very difficult. And I would be lying if I said otherwise. But I think this if I had to lay blame anywhere I think I probably lay it on the baby boomers. I mean of well-to-do young people who I don't know where these new standards came from but they certainly developed out of much more forgiving standards when for instance 40 years ago or more I was raising my children you know on the other hand there are many things about today's standards that are that are quite admirable. But I just think it goes too far and it it it's. I do talk I do talk about child murder but the the the point that I

make is that I think based on the cases that I've read about which is obviously not all the cases there have been these women are generally either psychotic or badly dissociated at the time of the murder. And I talk about Andrea Yates which is a quite a tragic story. She was the woman from somewhere in the Southwest who drowned all five of her children to her she'd had repeated postpartum depression and. I think it's a very rare as as these things go are very rare. Well it depends on how hard you shake the baby doesn't it. You know I no I don't think so I think that. That that there's a there's a little piece by Anne Lamott in one of these chapters in which she talks about how much she loves her son and how there are times when she just like to throw him at the wall and you know she's never going to throw him at the wall. And you know you understand what it's like to have a college

baby be raising him by yourself. You know awake every night and loving him during the day time and just you know. I would also now say more awareness of the kind of precious rules that that surround raising children these days. I mean that's the only word I can use for it. You know it's time is not such an unusual example. I mean I've presented it with some hesitation because you know I don't I don't have any I'm not you know I think you're right. I'm I'm not from the south. And so I wrote I really wrote about a population I know fortunately re read. I mean that's another thing. But this doesn't surprise me and I'm sure it's not just in the South you know and there must be parts of the. And it may be partly a class thing and it may be a religious thing also. But I can't speak with any authority about that.

I say this somewhere in the book. I've never been a father. I'm not a man I'm writing from my point of view. I. My guess is that mostly men are not as ambivalent. But I'm sure they they struggle with it also. And there's another book out there waiting to be written you know by someone who's who's motivated to do that but the the job of the father really most of the time is is to is to provide a structure for the mother and child even if the mother works you know too but the father isn't expected to be responsible for the children you know in the same way that mothers are. I mean I know there are exceptions and that sort of thing but so I do talk about father son but I don't. I don't you know speculate too much about them. This lady is a nurse and a doula and she has been she has been she's commenting on the changes in the expectations for both child birth and early

child rearing that she sees and feels that there are helpful support groups around. I'm very glad to hear it I don't hear hear about it so much from my from my patients. I should say that yes there are differences in the kinds of things my patients tell me now than they were 20 years ago but I'm also more interested in it now. You know this was was not so much a subject that I had gotten my teeth into at that time. So it's it's a little bit hard to say. I think women always follow whatever the fashion is you know and the fashions were more forgiving 20 and 40 years ago. I think that a point I make in my last chapter is that unlike animals who breed and have young women know they're doing it and they know what the dangers are and you

know they they they have consciousness of what they're getting themselves into. And I think it breeds enormous worry and women who are used to being very perfectionistic in their lives period. It doesn't change when they when they have children in that. That's what I meant about the baby boomers without you know being too precise about it. Does that answer the question or of the women that I have talked about in the book none of them were homosexual. And I don't think I've had homosexual men in my practice but I don't think I've had any of the fat children. If I was seeing someone now I think would be more likely that they would than than when I started out. So I can't help you with that when you know. Cynthia is asking whether things between daughters and mothers tend can and tend to get better when the daughters have children without having any hard evidence on this. I gotta say yes you know because I just think that being a

grandparent is so much easier and you know it's so easy to be wise and patience and. You know I'm not all. Not all mothers get along with with their daughters better once. Once the daughters have children but I bet some pretty good percentage do. I don't have figures on this but but that's mostly because I think that I'm actually one of the cases I go into in depth in the book finds a mother this woman finds a mother who she had many many doubts and frustrations with to be a wonderful grandmother you know and very very helpful to her and I think that is not an unusual experience.