Wyatt, Caroline and Murray, Craig (2014) Postnatal mental distress : exploring the experiences of professionals, mothers, and significant others. PhD thesis, Clinical Psychology.
Abstract
This doctoral thesis explores issues related to postnatal mental health from the perspective of professionals, mothers, and significant others. It comprises a literature review, an empirical paper, a critical appraisal of relevant issues, and an ethics section. The literature review reports a meta-ethnographic synthesis of studies exploring the experiences of professionals working with women experiencing postnatal depression (PND). Five themes were identified: (a) conceptualising the label; (b) using ‘my antennae’: recognising PND; (c) ‘permission to speak’: facilitators and fears; (d) whose role is it anyway: professional confidence and expertise; and (e) ‘we’re not user friendly’: navigating the system. Clinical implications were highlighted, including the fostering of liaison between clinical psychologists and perinatal professionals, the importance of mental health training for perinatal professionals, and the development of clear care pathways for all severities of distress. The empirical paper focuses upon mothers who had experienced postnatal psychosis (PP) and their significant others. Seven dyadic interviews were conducted and analysed using interpretative phenomenological analysis. Four themes emerged: (a) ‘she wasn’t herself’: threatened relationships through loss of ‘normal’ self; (b) invalidation and isolation: relational dynamics in seeking, receiving and providing support; (c) ‘the worst life can throw at us’: shared perceptions of trust and respect following PP; (d) a double-edged sword: understanding relationships as negatively and positively influencing PP experience. The paper contributes to the evidence base by highlighting the opportunity for positive transformations in relationships following PP, despite the potential for strain within these relationships. Furthermore, it explores the novel finding that relationships can influence the content of unusual postnatal experiences. Within the critical appraisal, reflections pertinent to the empirical paper are offered. These span the three domains of conceptual, methodological, and ethical issues. The ethics section contains detailed information related to the process of gaining ethical approval for the empirical paper.