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Good Enough Mama: Exploring Body Image, Identity Shifting and Depression in Pregnancy and the Postpartum Period

Saturday, March 1, 2014: 10:50 AM-12:20 PM
Palm (TradeWinds )

Background: The desire to have children can be a motivating factor in eating disorder recovery, yet pregnancy and the postpartum period can mirror difficulties experienced in early recovery. This presentation will explore risk factors for relapse, postpartum depression, body image distress, as well as recovery hope for new and expectant mothers.

Content Outline Good Enough Mama:

1. PowerPoint Slideshow (60 minutes)

This slideshow will explore the issue of body image distress and how to address eating disorder recovery issues with pregnant and postpartum women. Topics will include: markers of eating disorder recovery that are essential to solidify prior to pregnancy and motherhood, similarities between early recovery from an eating disorder and early motherhood (sleep changes, mood changes, hormonal changes, appetite changes, body image difficulty/distress, new identity formation), and how to avoid and/or therapeutically manage inter-generational transmission of body image dissatisfaction. It will also compare media images of pregnancy and motherhood with actual experiences and bodies in pregnancy and postpartum. Finally, one woman's story of recovery from an eating disorder and Postpartum depression will be presented as a case study about therapeutic opportunities to examine identity and values during this period.

2. Screening tools for Eating Disorders and Postpartum depression (30 minutes)

During this portion of the presentation, screening tools for Eating disorders and for Postpartum depression will be presented in the form of handouts.

3. Guided Meditation and expressive arts on body felt-experience (60 minutes)

Participants will be invited to engage in a guided meditation about a changing body (10 minutes) followed by journaling (15 minutes), expressive arts exercise (20 minutes) and small group sharing (20 minutes). 

4. "Birthmarkings" Video (18 minutes)

This video shows women telling the stories of their stomachs postpartum. (Published on Apr 19, 2012, Margaret Lazarus, Your Voices: On Motherhood)

5. Question and answer (10 minutes)

6. Donald Winnicott quote about being "good enough" mother (2 minutes)


Seventy-nine percent of the women who have body fears related to motherhood name weight (getting bigger during pregnancy and not being able to lose the weight after delivery) as their number one fear.  – Mysko, Claire and Amadei, Magali

The moment a child is born, the mother is also born. She never existed before. The woman existed, but the mother, never. A mother is something absolutely new. -Rajneesh Look   

The desire to have children can be a motivating factor in eating disorder recovery, yet pregnancy and the postpartum period mirror the body changes and body image distress experienced in early recovery. After the liberation of throwing out the scale, recovering women are faced with constant weight monitoring during pregnancy and “fat chat” about “losing the baby weight” postpartum.

Both pregnant/new mothers and women recovering from eating disorders experience anxiety, body image distress, difficulty sleeping, hormonal changes, appetite changes, and ambivalence/excitement/distress around cultivating a new identity. Guilt and shame are also often prominent in both the experiences. How can recovering women travel this terrain without relapsing into their eating disorders? Markers of recovery (dis-identifying one’s identity from one’s weight, listening to one’s hunger cues and body rather than avoiding/numbing them, tolerating imperfection and ambiguity) and tools for recovery (distress tolerance, emotion regulation, support system, journal/art prompts, and medication as determined by Psychiatrists) will be shared. Signs and symptoms of postpartum depression and screening tools such Postpartum Depression Screening Scale and the Edinburgh Postnatal Depression Scale will be presented. Experiential meditation and expressive arts will help participants experience somatically what it is like to grow into a different body, as do recovering, pregnant, and postpartum women. A clinical case example of one woman’s story of experience in recovery from an eating disorder and Postpartum depression will be presented. The presentation will end with the concept of Donald Winnicott’s of being a “good enough” mother.

Primary Presenter:
Linda Shanti McCabe, MA, (1998), PsyD, (2009)

Dr. Linda Shanti McCabe, PsyD, is a Licensed Clinical Psychologist. Her doctoral research explores integrating expressive arts with healing body image distress. She has presented at the National Expressive Arts Association, Summit Eating Disorders Symposium and the Association of Professionals Treating eating Disorders conferences. She has worked with clients recovering from eating (mood, and personality) disorders at residential, intensive outpatient, and outpatient levels of care since 1999. She currently works at La Ventana Eating Disorders Program in San Francisco and has a private practice at the Association of Professionals Treating Eating Disorders.

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