Clinician Note: What Postpartum Women Need

What are postpartum women looking for when they come to therapy?

Simply put they are seeking compassion, information, support, reassurance, validation, expertise and guidance.

Your capacity to provide some of these without all of these will not sufficiently address the issue at hand as these concepts are inextricably entwined.  You cannot effectively validate without support.  You cannot guide without compassion, you cannot reassure without adequate information, and so forth.  You should take the necessary time to explore you own abilities and limitations in these areas.  Women asking for help during this time of their lives will accept nothing less and should not be expected to.  The philosophy behind these concepts should be evident:

Compassion: To show a special kindness and empathy to those who suffer.

Information: To educate with appropriate materials, data, evidence-based healthcare knowledge and choices.

Support: To provide unconditional acceptance and encouragement.

Reassurance: To restore confidence and reduce anxiety.

Validation: To provide evidence that a position or feeling is authentic and real.

Expertise: To speak with authority in this specialized field.

Guidance: To lead the way toward recovery with a prescribed course of action.

The process by which we impart these concepts involves a number of therapeutic strategies.  Fundamentally, it comes down to one thing, as it always does when discussing central principals of therapy – the relationship.  It doesn’t matter how many degrees you have or where you went to graduate school.  If she doesn’t feel comfortable sitting with you and looking you in the eyes, all our well-crafted words will fall upon deaf ears.

So you need to ask, do you feel equipped?  Capable?  Confident?

One of the first questions I ask a prospective therapist who is interested in working at our center is, “Are you a good therapist?”  Often, she looks at me as if this is a trick question, hesitating with ambivalence. She may be thinking: If I say yes, I’ll appear vain or arrogant. If I say no, I’ll appear unqualified.  If I say I’m not sure, I’ll appear indecisive.  But it’s rather simple to me.  I’m hoping I hear a “yes”.  After all, why would I want to hire her if she’s not a good therapist?  Now I understand that just because someone says she is good at something, doesn’t make her good at it.  But I can guarantee you this:  If she says she does not think she’s a good therapist, or she’s not sure, I suspect at the very least, she’d need better supervision and a great deal more experience.

The same principle holds true when a woman is sitting in your office and asks if you can help her feel better.

You can play therapist and ask her why it’s important for her to know.  Or you can deflect the question and grab onto another topic.  Or you can wonder privately to yourself whether you should come right out and answer her question.

Or you can just say, “Yes, I can.”

I think that’s the nicest way to respond. And certainly the most therapeutic.


(Excerpted from Therapy and the Postpartum Woman, Routledge, 2009)

Therapy and the postpartum woman Book Cover

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