Category: Family Therapy

Parenting Pressure and Postnatal Depression

Throughout the journey of new parenthood, every parent encounters challenges unique to them, their circumstances and their baby. Within the range of experiences, whether joyful, stressful, or educational, some are more openly discussed than others. Postnatal depression, despite being the most common complication for women who have just given birth, is often glossed over or avoided. In reality, this experience is widespread, perfectly natural, and must be addressed, the same as any other post-birth complication. Postnatal depression is sometimes incorrectly conflated with “baby blues”, a term for feelings of sadness many new mothers experience after having a baby (between 2 and 35 days post-birth) that can last up to two weeks.

Increased understanding of parenting techniques, spread through word-of-mouth, the internet and social media, has equipped new parents with abundant information. However, the wish to provide the best for their child can sometimes lead parents to set the bar overly high for themselves, burdening themselves with unrealistic expectations. These can then become a source of pressure and feelings of inadequacy, which profoundly affect parents’ mental and emotional well-being.

Although parents’ struggles can sometimes be dismissed or minimalised, they are significant and matter. Your mental well-being, as a person and a parent, is essential.

If you are struggling with mood changes, motivation or feelings of failure, it is essential to take these seriously. Unaddressed postnatal depression can lead to long-term impacts on your mental health and your baby’s development. Reaching out for support is beneficial—it’s a profound act of care for yourself and your little one.

Therapy and counselling can provide real, tangible support when addressing postnatal depression. Individual therapy can provide a confidential, nonjudgmental space to discuss your thoughts and emotions and help you find strategies to rebuild your resilience. Couples and family therapy can also support you and your partner or other family members in communicating your feelings in a way that promotes empathy and healing.

What is postnatal depression? 

Postnatal depression is the most common complication for new mothers. It affects up to 1 in 7 women and manifests differently between individuals. Researchers have found a wide variety of signs, onset times and durations. Sometimes, it can occur up to 18 months after delivery and develop gradually. Although it is more common in women, men can also develop postnatal depression, and it is equally important to address this with a healthcare professional.

Experiencing postnatal depression does not diminish your worth or your abilities as a parent. Societal stigma faced by parents who are struggling can sometimes lead people to attempt to mask or hide it, but this could exacerbate the issues. It’s vital to understand that postnatal depression is not something you can help, and it is not an indicator of your parenting skills or capabilities.

Sometimes, postnatal depression is incorrectly used as a synonym for “baby blues”. Baby blues occur within 35 days post-birth and can last up to two weeks. If feelings of sadness, anxiety or unusual mood last longer than two weeks, you must contact your GP, a therapist or another relevant health professional. You should urgently contact a healthcare professional if your feelings intensify, make it difficult to care for your baby or complete everyday tasks, or if you are having thoughts of harming yourself or your baby.

Signs of postnatal depression include:

• Feeling depressed most of the time
• Feeling panicked, scared or worried a lot of the time
• Feelings of worthlessness, guilt, inadequacy, failure or shame
• Severe mood swings
• Having little interest in things you usually enjoy
• Feeling tired all the time, having trouble sleeping or sleeping too much
• Significant changes to eating patterns and weight
• Difficulty concentrating or making decisions
• Having difficulty bonding with your baby
• Thinking about hurting yourself or your baby
• Thinking about suicide (killing yourself)
• Frequently crying
• Withdrawing from contact with other people
• Having doubts about your ability to parent, regardless of reassurance

Postnatal depression can make it much harder to look after your baby. While you may be managing the practical elements of parenthood, addressing this condition is essential for thoroughly enjoying and appreciating your experience as a new parent.

The impact of parenting myths on postnatal depression

The constant influx of new parenting philosophies and the pressure to adhere to the “ideal” way of raising a child can be a source of stress. While aiming to do the best for your baby is natural, striving for perfection during a whirlwind of sleepless nights, bottle sterilisation, and spit-up can escalate stress levels and feelings of inadequacy.

Many parents (and non-parents) buy various myths and theories about parenthood. Although these can be well-intentioned and sometimes based on substantial developmental theories, they are often merely idealised advice. Understandably, one-size-fits-all guidance aimed at millions of individual parents could inadvertently instill a sense of failure when it doesn’t align with their experiences, parenting styles, or practical realities.

Some parenting pressures and myths include:

• ‘I should be joyful and ecstatic all the time.’
• Loving a child too much will spoil them
• Parenting comes naturally to good parents
• Parenting will give you all of the fulfilment you need
• Children’s needs should always come first
• Perfect parents exist

Pursuing flawless parenting could significantly contribute to the many people struggling to acknowledge their difficulties openly. Social media, marketing, books and TV often fuel these myths. It’s important to remember that the myth of perfect parenthood is unattainable and incredibly lucrative. Embracing flexibility, versatility and adaptability with your baby’s best interests at heart can offer the freedom to evolve and flourish as a parent in tandem with your child’s growth. Discussing your thoughts around parenthood and whether they align with your reality with a therapist can help you adopt a more adjustable approach.

The impact of changing roles on postnatal depression

Going from being a couple to becoming new parents may feel like entering a new relationship dynamic. Suddenly, your established routines are upended, and the time you spend alone or together is significantly restricted. Parents may feel resentful of perceived inequalities between responsibilities or feel left out and helpless for not being able to do more.

Suppose you and your partner struggle to settle into your new parental roles. In that case, relationship counselling can provide real, tangible support in addressing communication issues, promoting self-care and shared support, and building positive parenting strategies. A trained integrative therapist can also support you in addressing past experiences and core beliefs which may be contributing to stress and anxiety.

How to address postnatal depression 

Coping with the complexities of postnatal depression often calls for the support and understanding of others. The adage “it takes a village to raise a child” reflects the courage and resilience it takes to reach out. Some things which may help include:

• Attending support groups, online or in-person, can be very effective in addressing postnatal depression. Although it can feel challenging to admit postnatal struggles to others, by sharing your feelings in a safe, confidential space, you can normalise your experience and begin to find ways to heal alongside others with similar experiences.
• Exercise and diet also play a huge role in mood. Even if you eat a piece of fruit every day, stretch, or go for a short walk, these can significantly positively impact how you feel.
• Seeing a counsellor can play a huge role in developing healthy parenting and communication styles, exploring challenges and creating strategies to address them. A skilled therapist can help parents explore emotional well-being and sources of external and internal pressure, leading to increased resilience in the face of parenting. Online couples and online family therapy can also be precious for improving communication, discussing needs and creating strategies for the future.
• Accepting and asking for help is vital. You may be surprised by how many other parents can relate to your experience and how willing others are to help. Just asking a friend or family member to look after your baby while you bathe or go out for a coffee can help you feel more like yourself.
• Revisit relaxing activities you enjoyed before giving birth. Do what made you feel good before becoming a parent – hobbies or classes, reading books and watching TV, chatting with friends, cooking, whatever makes you feel good and connected to yourself outside of your new role.
• Avoid stressful situations and big decisions. Moving house, changing jobs and starting or ending relationships are all examples of decisions that should be left until you feel mentally and emotionally resilient.

New parenthood is a transformative process, bringing about significant changes to lifestyle, routine, self-perception, perception from others and roles in life. It is entirely natural for such a profound change to impact how you feel about and within yourself. When experiencing postnatal depression, it is essential to seek support, address your concerns, and prioritise self-compassion.

When considering lasting connections, we often celebrate and admire enduring relationships between romantic partners and lifelong friends. We may think of how lucky couples are on their golden anniversaries, or cherish stories of people who met on the first day of primary school and are still good friends in their 60s. But there is a unique and profound relationship which is often underrepresented: the bond between siblings. We often know our siblings from our first days on earth to our last, and they shape us in ways we can never be fully conscious of.

How our sibling relationships shape us

In the UK, around 80% of people have at least one sibling. Our siblings are sometimes our first friends, rivals or confidants, and are often our longest-lasting relationships. They witness us through our formative life stages, acting as stable, enduring presences through life’s ups and downs.

“That shared perspective is one of the facets that makes sibling relationships so valuable for child development,” – Laurie Kramer, PhD, clinical psychologist, Northeastern University

In our childhood years, we often share a great deal with siblings, from parents and potentially a last name, home or bedroom, to formative experiences – whether enriching or challenging. For most children, time spent in the company of siblings surpasses any others during out-of-school time. And yet we are each entirely our own, autonomous person. No two siblings, even twins or triplets, navigate their upbringing with identical outlooks and experiences.

The significance of sibling bonds

During our formative childhood years, siblings, particularly those who are fairly close in age, are our first relationships where we live with people similar in age and outlook to us, preceding flatmates, friends or partners. We learn from our siblings, and they learn from us.

Karen Gail Lewis, PhD, whose career as a sibling therapist spans 50 years, explores in her book Sibling Therapy how deeply this reciprocal learning process between siblings shapes each individual’s life and identity. She highlights how early behaviour between siblings, whether this features rivalries and hurts or care and compassion, frequently serves as a blueprint in later relationships and interactions.

Lewis states that a myriad of issues in adulthood can be traced to sibling relationships, describing them as “a laboratory for all subsequent relationships.”

The patterns established in sibling relationships have been noted to affect us into adulthood. A child who felt intimidated by their sibling may grow into an adult who is particularly sensitive to perceived aggressive behaviour in others. Similarly, a child who is domineering over their siblings may find themselves replicating this behaviour in their later friendships and relationships. Therapy can play a key role in discovering how these past roles have impacted other relationships, and helping to create balance in interpersonal dynamics.

The transition from children to adult siblings

Adult sibling relationships can be incredibly complicated. Many adult siblings have a deep, enduring love and loyalty for one another, coexisting with a legacy of rivalries and jealousies. Therapy and counselling can be invaluable for adults seeking to navigate these multifaceted dynamics and improve their relationships with their siblings.

Numerous factors can impact our sibling relationships, including roles established in childhood, parental treatment, the environment we grew up in and formative experiences. For instance, expectations placed on the oldest child to take responsibility for the well-being of younger siblings can extend into adulthood. This can then foster feelings of resentment; the older sibling may feel burdened by the strain of their efforts and the younger may feel their autonomy as an adult is being overlooked.

Positive sibling relationships have been shown to significantly benefit emotional and mental health. However, strained relationships with adult siblings can have adverse effects. In the Harvard Study of Adult Development, researchers found that participants who had less supportive relationships with their siblings had a greater likelihood of major depression and substance use.

The value of enduring bonds between adult siblings

Our siblings connect us to who we once were. No matter the transformations we have undergone throughout our lives, our siblings create a bridge between us and our earlier selves, and this can be both grounding and beneficial. By maintaining connections with the people and experiences which shaped us, we can remain aware of how we became who we are today. This can help us nurture a greater level of self-awareness and insight.

Sibling relationships often act as a unique arena for the exploration and adaption of behaviours. Given the enduring nature of sibling relationships, we may find more freedom to explore different ways of interacting, with a lower likelihood of the relationship ending. This may occur unconsciously, but it offers ongoing learning which can enhance our other ties and interactions. This is not to advocate for intentionally experimenting with behaviour when interacting with adult siblings, but rather to acknowledge that there are valuable lessons to be gained.

Siblings are also more likely to be honest with us. Unlike friends and partners who may try to shield our feelings, responding with tact or politeness, siblings are likelier to offer straightforward feedback and tell us when we are being unreasonable or unfair. While this level of candour is not guaranteed, due to the relative stability of sibling relationships, they are more likely to tell us what we need to hear.

Adult siblings can also enrich our lives by having children and giving us nieces and nephews. This allows us to form meaningful relationships with children without the full-time responsibility of parenthood. We can become mentors, tutors and role models outside of, or in addition to, the role of parent. Similarly, when we expand our own families, we can also make our siblings aunts and uncles. This new dynamic can increase family closeness, and open up new avenues for confiding and sharing experiences – and responsibilities, such as babysitting.

Enhancing adult sibling bonds

• Dedicate time to spend together. Make a point of scheduling and prioritising this. Like all meaningful relationships, nurturing our ties with adult siblings requires ongoing effort and dedication. Building new memories can help to heal childhood wounds and rivalries, propelling the relationship into the present and laying the foundation for renewed connection.

• Have meaningful conversations. Venturing beyond small talk may feel awkward, especially if you and your sibling don’t interact much as adults. However, discussing more substantial topics is vital for closeness. There’s no need to delve straight into your deep-rooted childhood issues straight away, but opening up about experiences and asking for advice about work, relationships and life can help you to rekindle the authentic sibling bond.

• Be emotionally present, consistent and authentic. Our siblings, perhaps more than anyone else, can tell when we’re not being true to ourselves. By embracing honesty in our interactions, communicating honestly, apologising sincerely, being grateful when necessary, and bringing our true selves to the interaction, we can enhance our relationship with our siblings in a way which can make it feel safe to replicate with others.

• Seek support. Should you and your sibling encounter challenges in creating the close, loving relationship you seek, seeking professional guidance can be incredibly beneficial. It is a common misconception that relationship counselling is exclusively for romantic couples. A skilled and certified relationship or individual therapist can help you to see where both past and present behaviours are influencing your sibling relationship and how to move forward. Family counselling can also be incredibly valuable if you are seeking to improve relationships with more than one sibling, or if you would like to include your parents in the process.

Sibling relationships are both complex and profoundly impactful. Whilst readjusting to adult dynamics can feel daunting, our sibling bonds are a testament to our growth. These connections can link our past to our present, and provide avenues for exploration and growth.

Family relationships are influential in shaping children’s mental health and future. The bonds, dynamics, and dialogues within the family unit hold the power to imprint a child’s identity, sense of self, self-value and resilience. Like a mirror reflecting the world, children portray the beliefs, behaviours and emotions of those closest to them. The family’s role in nurturing a child’s mental health is profound, stretching from infancy to adulthood.

Family communication, dynamics, and roles significantly influence children’s development. Growing up, we absorb behaviours from our environment, learning how family members interact, resolve conflicts, form connections, and develop individual identities. As the primary social group, the family profoundly impacts a child’s behaviours in childhood, adolescence, and adulthood.

Establishing relational depth within the family unit forms the basis for emotional development and helps our children learn how to foster healthy closeness and communication. When children know they have a secure and loving family network to rely on, they become more resilient in navigating life’s challenges.

Family Relationships, Dynamics and Children’s Mental Heath

Family dynamics are the complex patterns, themes, interactions, and relationships which exist within a family unit. These dynamics are shaped by the individual personalities, roles that are given and taken, and communication styles of family members, as well as external factors such as culture, societal norms, and life experiences.

In family life, the internal thought processes of parents play a significant role. When supporting children’s mental health and journey of self-development, recognising the shadows of self-criticism is essential. Learning to traverse the harmful aspects of self-criticism, such as perfectionism, negative self-talk, fear of failure, avoidance of challenges, and low self-esteem, forms an important and integral part of development in children and adolescents.

Supporting the growth of your child’s self-esteem is integral to their emotional development. Parents can foster healthy self-esteem by consistently showing unconditional love, support, and affection. Demonstrating to children that they are appreciated and valued unconditionally is crucial. Physical affection, such as hugs, kisses, playing, and moments of quiet closeness, reinforce your child’s self-esteem. Verbal affirmations also play a vital role; saying ‘I love you’ often and offering words of encouragement and praise fosters emotional intimacy.

Childhood development of self-esteem carries into adulthood, so establishing a strong foundation for this will help them navigate emotions into adulthood and beyond.

Family relationships significantly influence dynamics for all members, including children, parents, and extended family. Demonstrating self-nurturing as a parent meets your needs and teaches children self-care through example. Allocating time for personal activities demonstrates how children can recognise and address their feelings and needs. In a nurturing environment, children feel safe to explore new experiences and push their boundaries, boosting confidence in making friends, trying new hobbies, tackling academic challenges, and seeking support when needed.

Family therapy is instrumental in fostering constructive communication, understanding, and growth by creating a space for family members to explore the nuances of self-critique and self-reflection without judgment.

It can be challenging to arrange for families to find a time and place to work through these challenges together, whether separated by distance or time constraints. Online therapy can become a bridge across these challenges, providing support in a flexible and accessible way for families to engage in the therapeutic process to strengthen their connections and understanding of each other and the dynamics present within their family.

Common Family Relationship Issues That Can Impact a Child

It is important to remember that no family is perfect, and every family encounters challenges throughout their lives. Common family relationship issues that can impact children’s mental health and emotional development include various factors and dynamics that influence their emotional well-being.

• Parental conflict or divorce
• Lack of communication within the family
• Financial stress or instability
• Substance abuse or addiction within the family
• Parental mental health issues
• Domestic violence or abuse
• Neglect or lack of emotional support
• Sibling rivalry or conflicts
• Loss or death of a family member
• Changes in family structure (e.g., remarriage, step-siblings)
• Moving or frequent changes in schools or homes
• Inconsistent discipline or boundaries
• High levels of parental expectations or pressure
• Lack of boundaries

Children’s Mental Health and The Role of Family Boundaries

The role of family boundaries in children’s mental health is significant. Clear and appropriate boundaries within a family contribute to a child’s emotional well-being. Some key aspects of how family boundaries impact a child’s mental health include:

Security and Safety: Well-defined boundaries provide children with a sense of security and safety. Knowing what is expected of them and what behaviours are acceptable helps children feel protected and reduces anxiety.

Emotional Regulation: Healthy family boundaries teach children how to regulate their emotions. They learn to express their feelings appropriately and understand that seeking support from family members is okay when needed.

Independence and Autonomy: Appropriate boundaries encourage children to develop a sense of independence and autonomy. They learn to make choices and decisions within the framework of family rules, which helps build self-confidence and self-esteem.

Respect and Empathy: Respect for boundaries within the family fosters empathy and understanding. Children learn to respect the personal space and feelings of others, which enhances their interpersonal skills and relationships.

Role Clarity: Clear boundaries define roles and responsibilities within the family. When children know their roles and understand their place within the family structure, it reduces confusion and conflicts.

Healthy Family Relationships: Understanding boundaries is essential for building healthy relationships outside the family. Children who have experienced appropriate boundaries are more likely to establish respectful and balanced relationships with peers and later in life.

Prevention of Enmeshment or Neglect: Well-established boundaries help prevent two extremes in family dynamics: enmeshment (lack of personal space and independence) and neglect (lack of emotional connection and support). Both can have adverse effects on children’s mental health.

Stress Reduction: Healthy boundaries within family relationships can help reduce stress and tension within the household. When everyone understands their boundaries, it positively impacts a child’s mental well-being.

Communication Skills: Healthy boundaries encourage open and effective communication within the family. Children learn to express themselves and listen to others, enhancing their communication skills, which are crucial for mental health.

Emotional Resilience: Children who grow up with well-defined boundaries are better equipped to handle life’s challenges and setbacks. They develop emotional resilience and coping strategies that serve them well in adulthood.

Family boundaries play a crucial role in shaping children’s mental health by providing a stable and supportive environment that fosters emotional regulation, independence, respect, and healthy relationships. Properly managed boundaries contribute to a child’s overall well-being and prepare them for a successful and fulfilling life.

Nurturing the Family is Nurturing the Child

The word “nurture” shares a Latin root with the word “nourish”. It is no coincidence, then, that promoting healthy mental and relational growth in children requires conscious, deliberate care. Recognising that the health of family connections is intertwined with the way individuals perceive themselves within the family unit plays a powerful role in empowering healthy connections.

Parents can support emotional health in children by:

Building a safe and close personal relationship with them, providing structure, teaching boundaries, fostering independence, encouraging healthy social connections and safe habits, and modelling positive behaviours. Consistency in interactions with children fosters closeness and security.

Supporting your child in trusting themselves, teaching your child that they can learn how to process and understand their own feelings and how to communicate those feelings to others healthily. Teaching children to trust themselves can result in them being able to make decisions that will protect them from harm, such as leaving a party that has become an unsafe environment as a teenager or young adult.

Engaging in family therapy as an instrumental tool in forming a deeper understanding of the unique dynamics within individual family units can support creating, enhancing and maintaining healthy family bonds.

Allowing children to work through difficulties, fostering self-confidence, and encouraging persistence. While it can be difficult not to fix all of your children’s issues, providing support and normalising the initial challenges of new activities can help to build confidence and independence.

Demonstrating self-care and modelling. Children learn to manage their emotional well-being by observing compassionate behaviour, fostering their ability to navigate life’s challenges.

Meet Julia Halpin, a UKCP Family and Systemic Psychotherapist with over 35 years of experience working within the NHS. With a background in mental health nursing, Julia has a deep understanding of the stressors that can impact individuals and families. Her interest in working collaboratively with families grew from witnessing changes individuals made in their lives that influenced their relationships with family and friends. This drew her interest in working with families due to her belief that supporting one another can bring about positive change and enhance family relationships.

What are the benefits of Family Therapy?

Julia’s approach to therapy is grounded in exploring solutions with families, building on their unique strengths and resources. She believes that Family Therapy offers families the space to better understand their relationships and patterns of interaction, developing new interaction patterns and more positive relationships.

What are the pros and cons of offering Online Therapy? 

When it comes to Online Therapy, Julia recognises the benefits of accessibility and convenience for families with travel difficulties or who live in different locations and/or are in long-distance relationships. However, she also acknowledges the challenges of limited camera space for larger families and the difficulty of picking up on non-verbal cues through Zoom.

What is the most challenging part of your Psychotherapist role? 

As a Systemic Psychotherapist, Julia’s biggest challenge is keeping all family members’ perspectives in mind and avoiding taking sides. She emphasises the importance of appreciating each family member’s viewpoint, helping them develop different perspectives to understand each other better.

What approach would you use with a family where one person is neurodivergent? 

When working with a family where one person is presenting with neurodiversity, Julia’s approach is to help the family understand how neurodiversity affects communication, patterns of interaction, routines, and sensory sensitivities. This promotes greater understanding and improves family relationships.

In your experience of working with self-harm, do you feel this starts at an early age or it can develop at any stage in a person’s life? 

Julia has experience working with self-harm, for those individuals experiencing self-harm, there is a more significant number within the teenage and young adulthood years, although it is not confined to this age group. The proportion of people who self-harm has been increasing over the years across all age groups, with a greater increase in young people.

What approach would you use going into an initial session for Divorce Counselling within a family? 

For divorce counselling, Julia’s initial approach is to negotiate with the couple about having open and honest conversations about their relationship, discussing themes such as the ending of their relationship, children, living circumstances, finances, and what their “new” relationship might look like.

What is your approach to working with bereavement within a family unit? 

In working with bereavement, Julia finds that a family approach can be helpful in exploring complex thoughts and emotions within a safe and supportive framework. By working through the grieving process together, families can develop better communication and cohesiveness, enabling family members to feel more supported.

Do you have a specific specialism that interests you more than others?

While Julia doesn’t have a specific specialism, she is interested in working with families affected by neurodiversity and mental health challenges. Her collaborative approach emphasises working together to discover what works in achieving realistic goals, drawing on the unique strengths and resources of each family.