Using Hope-Based Interventions to Alleviate Psychological Distress During Matrescence
The role of hope enhancement interventions are not adequately assessed as a potential remedy to the psychological distress that is prevalent in the process of matrescence. This paper examines if hope enhancement strategies have the potential to alleviate psychological distress during the process of matrescence, specifically during the postnatal period. In reviewing literature on matrescene, postnatal anxiety, and hope theory this paper seeks to provide insight on whether hope enhancement strategies can assist in creating a more optimal psychological environment throughout the process of becoming a mother.
In an effort to better understand how hope enhancement strategies may play a role in alleviating postnatal anxiety, we must first define the associated terms and identify the psychological and neurological changes that this process activates. Matrescence, initially conceived as an anthropological concept (Raphael, 1975), has more recently been applied to psychology and defined as the transition into motherhood through preconception, pregnancy and birth, surrogacy or adoption, to the postnatal period and beyond (Athan & Reel, 2015). Throughout this process, and similar to any developmental push, mothers experience an acceleration in multiple domains: bio-psycho-social-cultural-spiritual (Athan & Reel, 2015). A staggering one in five mothers experience postpartum depression, more than half of new mothers experience the “baby blues” (Tucker, 2022, p. 12), and experiencing anxiety throughout matrescence is even more common (Barnett, 2023, p. 77; Kleiman, 2022, p. 47). Similar to generalized anxiety disorder, anxiety throughout matrescence can include physical manifestations such as nausea and sleep problems, as well as constant worrying, panic (Kleiman, 2022, p. 47), and invasive ruminating thoughts (Kleinman & Wenzel, 2020).
Although there isn’t unanimous agreement on what mediates anxiety throughout matrescence, there is evidence that neurological shifts, precipitated by hormonal changes make new mothers more vulnerable to psychological distress (Daws & Rementeria, 2021, p. 97). This includes a massive loss of grey matter from neurological pruning that occurs to create a hyper-vigilance in order for mothers to be able to predict danger (Daws & Rementeria, 2021, pp. 97-98). However, the stresses that threaten modern mothers the most are often not catastrophic events that require short periods of hyper-vigilance as evolution has prepared for but rather chronic, and often invisible problems such as poverty and hunger leaving some mothers under constant duress which can disrupt their most fundamental maternal habits (Tucker, 2022, p. 171). In looking toward hope enhancement strategies as a resolution, the plasticity of the ventromedial prefrontal cortex-dorsal raphe nucleus circuit, dubbed the hope circuit, translates to the ability to shift perception and to learn hope (Maier & Seligman, 2016).
Thus the application of hope enhancement interventions linked to the three hope theory tenets of goal-setting, pathways, and agency thinking (Snyder, 2002) can invoke a learned hopefulness that has the potential to combat psychological distress throughout the process of matrescence. Appropriate goal-setting is critical as this component of hope theory sets the tone of a person’s ability to cultivate a high-hope mindset (Tomasulo, 2020). Hope theory defines hope as a perceived capability to derive pathways to desired goals, and motivate oneself via agency thinking to use those pathways (Snyder, 2002). When studying hope in cancer patients it was found that, “if a person perceives they are advancing towards a goal, their tendency to engage in pathways and agency thinking readjusts to reflect this goal success” (Corn et al., 2020, p. 452). It is important to note that in this context, starting with more basic goals is recommended because “postpartum women are forever fraught with the pressure to do something…providing specific goals at the outset can ease initial anxiety.” (Kleiman, 2022, p. 94). This notion aligns with the findings of appropriate goal-setting in hope theory which recommends setting micro-goals (Tomasulo, 2020, p. 100), that are genuinely meaningful to the person (Snyder et al., 2023, p. 128), and having a variety of goals with readily available new goals should an original goal prove unreachable (Snyder, 2002, p. 253).
Most importantly, the function of setting micro-goals is not to attain the goal but rather to guide the goal-setter to receive feedback, shift their perception and to be in the flow which allows them to be in the present moment (Tomasulo, 2020, p. 21). Being present heightens mothers’ capacities for intuition, compassion, and connection (Athan & Miller, 2005, p. 28) which creates an optimal environment for attunement with their baby leading to huge spikes of estrogen and oxytocin, which promote loving feelings and caregiving behaviors (Daws & Rementeria, 2021, p. 99). Postnatal anxiety can in many cases be prevented or recovered from by being present which allows attunement with your baby leading to the cultivation of an intimate relationship (Daws & Rementeria, 2021, p. 105). In addition to goal-setting, other hope enhancement strategies including dispositional mindfulness techniques have a similar effect of shifting attention to the present which would allow mothers to notice their thoughts and feelings and thus create a sense of agency by instilling them with the power of choice in how they engage with their baby (Tomasulo, p. 54).
In addition to encouraging attunement, goal-setting and associated warm-up interventions anchored in hope theory have the potential to ease anxiety throughout the postnatal period by prompting a shift in perception that allows mothers to be in a flow state rather than stuck in a negative spiral of ruminating thoughts. Additionally, the shift in perception and adjustment of expectations prompted by appropriate goal-setting allows mothers to experience a surrender of control. It’s typical for new mothers to be bombarded with thoughts stemming from comparing themselves to others (Clements & Nixon, 2022), and not feeling adequate or in control (Barnett, 2023, p. 76; Kleinman & Wenzel, 2020) leaving them stuck in a negative thought pattern where rumination causes a downward spiral (Athan & Miller, 2005, p. 19). In the most advanced industrialized societies with the least robust family policies including the United States, this effect is compounded by the “rosy view” of parenthood that presents unrealistic expectations on new mothers (Athan, 2020, p. 451).
By leaning into hope enhancement strategies including gratitude practices and strength-based interventions, mothers plagued with ruminating thoughts can begin to shift their perception of their capabilities and ease the unrealistic expectations that burden them. For example, generating gratitude through cognitive means such as reflection, expressive means such as journaling, and sharing gratitude with others, serves to positively alter the biochemistry and neural pathways in the brain spurred by consistent shifts in perception, expectations and experience (Tomasulo, 2020, pp. 21–28). Another example of a hope-enhancing intervention is strength-spotting which can provide a gateway for mothers to understand their own character strengths and translate these into appropriate micro-goals. A proposed flow of strength-based interventions include the “peak experience” exercise, followed by an exercise where one imagines their life devoid of their character strengths, and then a further exploration of how they are over or underutilizing these strengths (Tomasulo, 2020, pp. 75–87). Furthermore, there are many paths to being a great mother based on each person’s personal strengths and this realization can assist in activating pathways and agency thinking.
In conclusion, there is evidence to support the potential for hope enhancing interventions to remedy the psychological distress that remains prevalent throughout the process of matrescence. However, the available literature warrants more empirical evidence and further research to establish a clear connection between addressing postnatal anxiety with the application of hope cultivation strategies. A case can be made for the role of hope enhancement interventions in creating a more optimal environment throughout the process of becoming a mother based on the capacity of these strategies to bring mothers into the present moment and to address ruminating thoughts by shifting their perception of their capabilities to ease the unrealistic expectations that burden them. Therefore, a need exists to further examine and unlock the potential of hope-based interventions in the treatment and gradual prevention of postnatal anxiety.
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