Clinical commentary

Background

Lisa is a teenage mother who became pregnant at the age of 15. She seemed very confused about how her baby was conceived, having had sex only once and not really knowing what had happened and how it had happened. Her own mother was unable to provide support for her pregnant teenager and her father did not want Lisa to remain in the house. As a result, Lisa went to live with an older friend/leader from her youth club who also became her birthing partner. When baby Anna was born, Lisa did not really have the chance to bond with her as the youth club leader, who did not have her own children, took over, getting up in the night, making bottles and soothing Anna to sleep. As a result, baby Anna was moved to a foster (mother and baby) placement but Lisa had to wait a week before she could join her baby. This difficult start and early separation added to Lisa’s depressive feelings, despair and sense of disconnection, not only from her baby, but from herself and also from her own mother whom she felt had never really loved her.

Lisa was referred to me as part of a perinatal service for depressed mums. Following an initial meeting with her and baby Anna, we agreed that she would see me weekly and that we would work towards alternating sessions with baby Anna with sessions on her own. This plan was supported by both Lisa and baby Anna’s social workers who agreed that the foster carer would look after baby Anna while Lisa had individual sessions. The session below is my third meeting with Lisa and baby.

Session

Lisa is early and waiting outside with her foster carer from the mother and baby placement. I have arranged an early appointment at 8.45 a.m. as Lisa finds it harder to attend later in the day and Anna has been waking very early, so Lisa is up and at a loose end. Lisa has also talked about how lonely she feels at the start of the day. Anna (eight weeks old) is sitting in her car seat, snuggled in but wide awake. She slept through much of the last