Case Study: Using Art Therapy for a Client with Postpartum Depression

Becoming a new parent can be an exciting, yet daunting period in a person’s life. A newborn baby can be very demanding as they require constant care. Newborn babies also disrupt sleep for parents which can impact the cognitive and emotional ability of parents to cope with these new demands.

Research indicates that 1 in 10 women may experience depressive symptoms during the postpartum period. Many more will experience a spectrum of negative emotions during this period.

When a mother experiences postpartum depression, this can impact the attachment outcomes between mother and child. This disrupted attachment can then impact the child through behavioural, physiological, and biochemical dysregulation.

Mother and child constantly exchange cues to signify attachment, learning, and safety for the infant. If the mother remains disconnected from the infant due to postpartum depression (PPD), this can impact the ability of the infant and mother to exchange these important developmental cues.

Over time the infant learns about emotional regulation from their mother based on facial cues and physical expression of emotion. A mother with PPD may not be exchanging clear positive cues and emotions and instead, the infant may end up developing a stronger connection to the depressive features of a mother with PPS.

There is a stigma associated with mothers who experience postpartum depression. To some women, it signifies a failure as a parent and therefore has a significant impact on self-esteem. This can affect a mother’s desire to verbalize her thoughts and feelings in traditional talk therapy if she feels voicing her thoughts will further influence the perception of her as a parent who can’t cope with her own baby.

CHARACTERISTICS OF POSTPARTUM DEPRESSION

The most common symptoms of postpartum depression include:

• Irritability
• Anxiety
• Panic attacks
• Sleep disruption
• Reduced concentration
• Feeling overwhelmed
• Exhaustion
• Appetite disruption
• Obsessive behaviours (eg. Attention to cleanliness around baby)
• Difficulty bonding with your baby
• Social isolation
• Reduced interest in activities
• Thoughts of harm or suicide to self or baby

Postpartum depression can be triggered by a number of different aspects to a new mothers experience which is individual to each new mother. The progression of PPD can also be connected to previous life experiences of the new mother, including her connection to her own mother.

The most common events connected to PPD include:

• Birth experience
• Biological causes (hormone production)
• Impact on interpersonal relationships
• Expectations from social norms of motherhood
• Previous negative life experiences

HOW ART THERAPY CAN HELP WITH POSTPARTUM DEPRESSION

Art therapy can help overcome this obstacle to participating in therapy that talk therapy may present. Art therapy allows the client to express themselves in artworks that are more meaningful to their own experience and not filtered through the use of words to a therapist.

Art therapy can help new mothers explore their new identity as a mother and help foster a sense of competency as a person through creative expression.

Art therapy is especially useful in groups as it provides mothers with a social support network with other mothers who may be struggling with their new roles as mothers.

Art therapy activities can help mothers develop a birth narrative based on their experience giving birth. Mothers can learn to process difficult birth experiences and reframe trauma as well as other difficult postpartum challenges.

Art therapy can help mothers explore their emotional experience of becoming a mother and developing a routine of self care as they learn more about how motherhood impacts their identity.

• Name: Susan
• Age: 29
• Summary of sessions to date: Susan had originally been diagnosed with PPD. Her GP suggested art therapy as a means to augment her treatment. Susan had attended two sessions to date where she had discussed her primary symptoms of PPD.

Susan worries about the health of her baby Liam. She reluctantly puts him to sleep and then spends at least an hour checking into his room regularly to see if he is ok. She then goes to bed and listens intently to the baby monitor to ensure he is breathing. She feels exhausted and obsessive about this activity and is starting to resent Liam for creating such disruption.

This art therapy exercise is primarily focused on helping the client to reduce feelings of anxiety which are presenting as obsessive behaviours. The goal at this time is to help the client achieve relaxation goals so that she can start to change her anxious and obsessive behaviours. The client will benefit from using artwork to help reduce feelings of anxiety so that other therapeutic work can take place.

INSTRUCTIONS:

• Check in with your client as to their current level of anxiety so that you obtain a self-reporting baseline of how your client currently feels.
• Explain the concept of mandala’s to your client and ask them to choose some art materials they would like to use to create a mandala. This mandala can represent the beginning of healing to your client through a process of relaxation, self-care, and creativity
• Ask your client to take a few minutes before creating their mandala. The client can use some deep breathing techniques to help reduce feelings of anxiety. The client may also like to use this time to visualise a process of letting go and exploring their creativity through the art exercise.
• Ask your client to create their mandala. Encourage your client to create while letting go of expectations and preconceptions.
  After the art exercise is completed, discuss with your client how the process of creating the mandala impacted their levels of anxiety.
• Check in with your client as to their current level of anxiety so that you obtain a self-reporting affect of how your client currently feels after completing the exercise.
• Discuss with your client the prospect of anxiety reducing techniques and how this can positively impact behavioural changes.

SUPPLIES USED INCLUDE:

• Angora Watercolour Pan Set http://amzn.to/2hLxtf1
• White Sharpie Paint Pen Medium http://amzn.to/2j36ChW
• Black Fude Ball Pen http://amzn.to/2k9pjhB
• Simply Simmons Brushes http://amzn.to/2hramK7
• 18 Brush Pens Set For Drawing Watercolor Pen http://amzn.to/2BmbXrD
• Faber Castell Big Brush Pen Black http://amzn.to/2lLN7fp
• XL Watercolour Pad (trimmed to 12×12 inch) http://amzn.to/2gGdja2
• Water Bottle

On a scale of 1-10, Susan felt her anxiety levels were 8 prior to completing the art exercise. After the exercise, Susan felt her anxiety levels had reduced to 5. She could see that a self-care activity such as art could help her regulate her emotions. The art exercise did not feel difficult for her and she felt she could also engage in other self-care activities to help reduce her anxiety. She felt it was important to remember that these activities could be simple and yet have an impact. The mandala that she created felt like a strong reminder of the power of how she could heal from her anxious feelings.

This case study represents a snapshot of the client’s progress in treatment. The exercise in this article could be used as written or as a guide for new and original tasks developed by the Art Therapist. Responsibility for treatment resides with the individual therapist who understands their clients specific needs. The art therapy exercise should not be viewed as a pre-defined directive on how to treat a client that presents with a specific range of problems.This art therapy exercise will help build a database of knowledge to draw upon when helping your client. Art Therapy is associated with psychotherapy techniques, however each therapist often approaches therapy with their own foundation of psychological interventions, whether it be psychotherapy, CBT, DBT or other methods.