Variables Associated with Unusual Thoughts

The association between anxiety symptoms and frequency of unusual thoughts was consistent with the links identified between anxiety and threat themed delusional thoughts (Morrison, 2001; Freeman & Garety, 2003; Kaney, Wolfenden, Dewey, & Bentall, 1992) and associations between anxiety symptoms and psychotic-like experiences in non-clinical populations (Varghese, et al., 2011). Close examination revealed that themes of the most commonly reported participant thoughts were consistent with emotions of fear and anxiety, suggesting that some of these thoughts might be manifestations of an underlying sense of threat experienced during this stage. As discussed earlier, in the non-clinical population a normalising explanation is that raised anxiety and activation of these thoughts in conscious awareness may serve as an adaptive function. Alerting mothers to the ways in which they themselves or external forces could harm their infants, increasing vigilance to the worst possible outcome in order to ensure that it does not occur. Theoretical understanding of the emotional regulation system suggests that activation of the brain’s threat response is an adaptive function in new, unfamiliar or unsafe circumstances, manifested in thoughts and responses that may be focused on potential threat (Gilbert, 2009). The response only becomes problematic in cases of repeated or prolonged activation. Therefore, a period of seemingly irrational processing (Welford, 2012) may be functional to the mother’s assessment of her new-born’s safety and therefore its survival. Additionally, other types of unusual thoughts might be understood as an internal sense of threat related to the mother’s own feelings toward the new infant. For example strong or unexpected emotions, a lack of expected emotion, fears relating to responsibility or power over the infant, and connecting with a new unfamiliar relationship. Of course the results only indicated association, at a moderate level, suggesting that anxiety symptoms are only one variable

associated with the occurrence. Furthermore, the experience of unusual thoughts may have increased the mothers’ anxiety symptoms rather than anxiety influencing frequency of thoughts.

Higher depressive symptom scores, whilst within the non-clinical range, were also associated with the frequency of unusual thoughts. A finding consistent with a number of studies indicating that both anxiety and depression symptoms are significantly associated with self reported psychotic-like experiences and delusions in nonclinical populations (Varghese et al., 2011; Wigman et al., 2011) and theory that psychosis and depression may be interrelated phenomena existing on the same continuum (Verdoux et al., (1999). Additionally, examination of some of the more common themes of ‘death and impending doom’ and ‘safety of the baby’ indicate consistency with Hall & Wittowski’s, (2006) study of cognitions associated with depression in mothers during the postpartum. When experiencing threat, evolutionary safety strategies are not only preparation for fight or flight, but also include submission, withdrawal and disengagement as a strategy of protecting oneself from further psychological pain (Gilbert, 2009). For example, a response to a social or relational threat can be disconnection, loss of affiliation and when the threat is persistent can lead to depression (Gilbert, 2009). Beck (1996), from interviews with 12 women experiencing postnatal depression, found that feeling overwhelmed by caring responsibilities and the fear that they would be unable to cope with the infant, led to the mothers “unconsciously erecting a wall to separate themselves emotionally and physically from their children” (cited in Hagen, 1999). The mothers in phase one of the current study illustrated thoughts of physical separation in their descriptions of wanting to abandon their babies when feeling overwhelmed; indicating that these difficult emotions are not limited to women with diagnosed mental illness.

Thus an increase in thoughts, depicting the infant in catastrophic circumstances might lead to increased depressive symptomology, reduced affect and affiliation as a psychological form of protection in the case of infant death or in managing the internal threat of shame in feeling unable to cope with mothering responsibilities. Alternatively, feeling intensely overwhelmed by

fated’, is ‘evil’ or ‘to be feared’ (content identified in mothers with psychosis - and a small percentage of non-clinical mothers in the current study) function to psychologically distance a mother from the infant; a current source of overwhelming threat. In clinical mothers, both depression and psychosis have been linked to thoughts of infanticide, the most extreme method of physical and psychological separation. If as theory suggests, there exists a continuum spanning neurosis and disorder (Peters et al., 1999; Johns & Van Os, 2010; Bentall, 2003) then in some proportion of the 70% of mothers, who experience non-clinical levels of depressive affect (baby blues), we might expect less extreme thoughts of this nature. Evolutionary theorists have suggested that postpartum depression may serve a function of rallying support for the mother in caring for her infant (Hagen, 1999) and from this perspective unusual thoughts may alert a mother to feeling overwhelmed and the need to seek support. When thoughts are shared women may gain the reassurance or support needed, when they are supressed or hidden due to being considered unacceptable, secondary distress may ensue.

Interestingly, whilst literature has associated sleep disruption, a common feature of the postpartum, with psychotic-like experiences (Hunt & Silverstone, 1995; Freeman, Pugh, Verontsova, Southgate, 2009), the current study found only a weak correlation between sleep duration and unusual thoughts. It may be that this weak association reflects slightly less settled sleep in light of women’s morbid concerns regarding sudden infant death syndrome. However, as stated the associations were weak and the findings of this study do not suggest that the unusual thoughts found in this non-clinical sample were largely linked to poor sleep. Lower levels of satisfaction with childbirth experience also had weak correlation with unusual thought frequency when significance levels were reduced, suggesting that anxiety and depression symptoms may play a much stronger role than other variables in mediating the experience of unusual thoughts in the postpartum. Further research in a larger sample would be beneficial in investigating strength of predictive factors.