Recently I consulted with two mothers of twins seeking help to understand why they have felt persistent guilt feelings since the birth of their twins a few years ago. In both these cases the birth of twins was spontaneous and natural, with no fertility issues. Initially, neither of these moms relished the idea of having twins. Both felt robbed of the traditional rituals and experiences that normally accompany the birth of a singleton. One mom was enormously disappointed that her longings for a vaginal birth were frustrated when the obstetrician informed her that a C-section was imperative given the position of both babies. Moreover, after the birth of the babies born at 37 weeks, she was not emotionally prepared for their week stay in the NICU. As we spoke together about these experiences, it became clear to both of us that her gnawing feelings of self-condemnation and inadequacy were directly related to her inability to give herself permission to feel anger and sadness about how much the twin birth had disturbed and disrupted her romantic expectations about motherhood. There was no one with whom she could share these expectable ambivalent feelings. Sadly, twin moms often do not have access to others that can empathize with the enormity of their situation while understanding that these feelings have nothing to do with not loving or wanting their children. Twin moms need this specific support to trust that negative emotions associated with adjusting to motherhood do NOT erase or minimize the love and concern they have for their babies.

Another mom spoke to me about feeling depressed and disconnected since the birth of her twins. She shared a harrowing story of having to spend months on bed rest in the hospital until she gave birth to her healthy twins. She had been told that it was of the utmost importance to stay positive during the hospital stay because becoming upset might induce contractions. She had never had the opportunity to understand the emotional impact of this experience. I explained that if traumatic feelings from past experiences are not revisited and relived, we dissociate. In other words, we push aside or “forget” threatening thoughts because it feels enormously uncomfortable to think about them. However, the price we pay for protecting ourselves in this way can develop into a self – destructive and depressive quality that interferes with our feeling connected and adequate. In many cases excessive guilt covers up unconscious or conscious feelings of anger and sadness.

I want to quote a few passages from a chapter written by a British psychoanalyst named Dana Birksted-Breen published in a book entitled Spilt Milk: Perinatal Loss & Breakdown, edited by Joan Raphael-Leff.

“postnatal blues” . . . relates to a state of mind surrounding a physically and emotionally taxing major event, particularly if it took place in unfamiliar surroundings and in an atmosphere of emergency, leading to feelings of relief, exhaustion, heightened sensitivity to circumstances, disorientation, etc. . . women who coped well with the experience of having a baby tended to modify their idea of what a mother should be like from an idealized one to a more realistic one. Postnatally, a good mother was now felt to need, for instance, to be diligent, hard-working, reliable, and to like being at home with children. The women who did not cope well, on the other hand, retained an image of a good mother as “loving,” “patient,” “unselfish,” “never losing their temper,” and they felt themselves to be at odds with this image of the perfect, selfless mother.