TED Residency
Alexandra Sacks: A new way to think about the transition to motherhood
Filmed:
Readability: 3.9
1,882,403 views
When a baby is born, so is a mother -- but the natural (and sometimes unsteady) process of transition to motherhood is often silenced by shame or misdiagnosed as postpartum depression. In this quick, informative talk, reproductive psychiatrist Alexandra Sacks breaks down the emotional tug-of-war of becoming a new mother -- and shares a term that could help describe it: matrescence.
Alexandra Sacks - Reproductive psychiatrist
Alexandra Sacks, M.D. is widely recognized as the leading clinical expert on matrescence: the developmental transition into motherhood. Full bio
Alexandra Sacks, M.D. is widely recognized as the leading clinical expert on matrescence: the developmental transition into motherhood. Full bio
Double-click the English transcript below to play the video.
00:13
Do you remember a time
when you felt hormonal and moody?
when you felt hormonal and moody?
0
1309
3930
00:17
Your skin was breaking out,
1
5263
1984
00:19
your body was growing
in strange places and very fast,
in strange places and very fast,
2
7271
4102
00:24
and at the same time,
3
12235
1157
00:25
people were expecting you to be
grown-up in this new way.
grown-up in this new way.
4
13416
2959
00:29
Teenagers, right?
5
17096
1311
00:31
Well, these same changes happen
to a woman when she's having a baby.
to a woman when she's having a baby.
6
19344
4811
00:36
And we know that it's normal
for teenagers to feel all over the place,
for teenagers to feel all over the place,
7
24179
4354
00:40
so why don't we talk about
pregnancy in the same way?
pregnancy in the same way?
8
28557
3355
00:44
There are entire textbooks written about
the developmental arc of adolescence,
the developmental arc of adolescence,
9
32850
5653
00:50
and we don't even have a word
to describe the transition to motherhood.
to describe the transition to motherhood.
10
38527
4211
00:55
We need one.
11
43271
1165
00:57
I'm a psychiatrist who works
with pregnant and postpartum women,
with pregnant and postpartum women,
12
45272
3230
01:00
a reproductive psychiatrist,
13
48526
1656
01:02
and in the decade that I've been
working in this field,
working in this field,
14
50206
2918
01:05
I've noticed a pattern.
15
53148
1720
01:06
It goes something like this:
16
54892
1956
01:08
a woman calls me up,
17
56872
1458
01:10
she's just had a baby,
18
58354
1681
01:12
and she's concerned.
19
60059
1438
01:13
She says, "I'm not good at this.
I'm not enjoying this.
I'm not enjoying this.
20
61521
4435
01:17
Do I have postpartum depression?"
21
65980
2206
01:20
So I go through the symptoms
of that diagnosis,
of that diagnosis,
22
68615
2365
01:23
and it's clear to me
that she's not clinically depressed,
that she's not clinically depressed,
23
71004
2989
01:26
and I tell her that.
24
74017
1480
01:27
But she isn't reassured.
25
75521
1893
01:29
"It isn't supposed to feel
like this," she insists.
like this," she insists.
26
77438
3155
01:32
So I say, "OK. What did you
expect it to feel like?"
expect it to feel like?"
27
80617
3292
01:36
She says, "I thought motherhood
would make feel whole and happy.
would make feel whole and happy.
28
84495
4657
01:41
I thought my instincts
would naturally tell me what to do.
would naturally tell me what to do.
29
89708
3427
01:45
I thought I'd always want
to put the baby first."
to put the baby first."
30
93606
2928
01:49
This -- this is an unrealistic expectation
31
97463
4121
01:53
of what the transition
to motherhood feels like.
to motherhood feels like.
32
101608
2511
01:56
And it wasn't just her.
33
104636
2048
01:58
I was getting calls with questions
like this from hundreds of women,
like this from hundreds of women,
34
106708
4955
02:03
all concerned that something was wrong,
35
111687
2650
02:06
because they couldn't measure up.
36
114361
2032
02:08
And I didn't know how to help them,
37
116956
2335
02:11
because telling them
that they weren't sick
that they weren't sick
38
119315
2610
02:13
wasn't making them feel better.
39
121949
1836
02:16
I wanted to find a way
to normalize this transition,
to normalize this transition,
40
124841
4281
02:21
to explain that discomfort is not always
the same thing as disease.
the same thing as disease.
41
129145
5403
02:26
So I set out to learn more about
the psychology of motherhood.
the psychology of motherhood.
42
134572
4058
02:30
But there actually wasn't much
in the medical textbooks,
in the medical textbooks,
43
138654
2874
02:33
because doctors mostly
write about disease.
write about disease.
44
141552
2617
02:36
So I turned to anthropology.
45
144725
1832
02:39
And it took me two years,
but in an out-of-print essay
but in an out-of-print essay
46
147148
3446
02:42
written in 1973 by Dana Raphael,
47
150618
3970
02:46
I finally found a helpful way
to frame this conversation:
to frame this conversation:
48
154612
4503
02:51
matrescence.
49
159139
1442
02:53
It's not a coincidence that "matrescence"
sounds like "adolescence."
sounds like "adolescence."
50
161672
4812
02:59
Both are times when body morphing
and hormone shifting
and hormone shifting
51
167174
3692
03:02
lead to an upheaval
in how a person feels emotionally
in how a person feels emotionally
52
170890
3704
03:06
and how they fit into the world.
53
174618
2249
03:08
And like adolescence,
matrescence is not a disease,
matrescence is not a disease,
54
176891
4159
03:13
but since it's not
in the medical vocabulary,
in the medical vocabulary,
55
181074
2822
03:15
since doctors aren't
educating people about it,
educating people about it,
56
183920
2687
03:18
it's being confused
with a more serious condition
with a more serious condition
57
186631
2789
03:21
called postpartum depression.
58
189444
1766
03:24
I've been building on
the anthropology literature
the anthropology literature
59
192444
2488
03:26
and have been talking
about matrescence with my patients
about matrescence with my patients
60
194956
3140
03:30
using a concept called
the "push and pull."
the "push and pull."
61
198120
2590
03:33
Here's the pull part.
62
201073
1424
03:35
As humans, our babies
are uniquely dependent.
are uniquely dependent.
63
203067
4321
03:39
Unlike other animals,
our babies can't walk,
our babies can't walk,
64
207412
2943
03:42
they can't feed themselves,
65
210379
1587
03:43
they're very hard to take care of.
66
211990
1883
03:45
So evolution has helped us out
with this hormone called oxytocin.
with this hormone called oxytocin.
67
213897
4873
03:50
It's released around childbirth
68
218794
2301
03:53
and also during skin-to-skin touch,
69
221119
2476
03:55
so it rises even if you didn't
give birth to the baby.
give birth to the baby.
70
223619
3271
03:59
Oxytocin helps a human mother's brain
zoom in, pulling her attention in,
zoom in, pulling her attention in,
71
227668
5469
04:05
so that the baby is now
at the center of her world.
at the center of her world.
72
233161
2836
04:08
But at the same time,
her mind is pushing away,
her mind is pushing away,
73
236567
5382
04:13
because she remembers there are
all these other parts to her identity --
all these other parts to her identity --
74
241973
4636
04:19
other relationships,
75
247434
1555
04:21
her work,
76
249530
1305
04:22
hobbies,
77
250859
1252
04:24
a spiritual and intellectual life,
78
252135
2527
04:26
not to mention physical needs:
79
254686
2268
04:28
to sleep, to eat, to exercise,
80
256978
3363
04:32
to have sex,
81
260366
1471
04:33
to go to the bathroom,
82
261861
1414
04:35
alone --
83
263299
1168
04:36
(Laughter)
84
264491
1169
04:37
if possible.
85
265684
1170
04:39
This is the emotional
tug-of-war of matrescence.
tug-of-war of matrescence.
86
267727
4034
04:44
This is the tension
the women calling me were feeling.
the women calling me were feeling.
87
272150
3415
04:47
It's why they thought they were sick.
88
275589
2280
04:51
If women understood the natural
progression of matrescence,
progression of matrescence,
89
279020
4941
04:55
if they knew that most people found it
hard to live inside this push and pull,
hard to live inside this push and pull,
90
283985
5643
05:01
if they knew that under
these circumstances,
these circumstances,
91
289652
2925
05:04
ambivalence was normal
and nothing to be ashamed of,
and nothing to be ashamed of,
92
292601
4550
05:09
they would feel less alone,
93
297175
2030
05:11
they would feel less stigmatized,
94
299229
2303
05:13
and I think it would even reduce
rates of postpartum depression.
rates of postpartum depression.
95
301556
4125
05:18
I'd love to study that one day.
96
306332
1944
05:21
I'm a believer in talk therapy,
97
309451
1848
05:23
so if we're going to change the way
our culture understands
our culture understands
98
311323
2829
05:26
this transition to motherhood,
99
314176
1794
05:27
women need to be talking to each other,
100
315994
2164
05:30
not just me.
101
318182
1322
05:32
So mothers, talk about your matrescence
102
320313
3629
05:35
with other mothers, with your friends,
103
323966
2647
05:38
and, if you have one, with your partner,
104
326637
2229
05:40
so that they can understand
their own transition
their own transition
105
328890
2887
05:43
and better support you.
106
331801
1625
05:45
But it's not just about
protecting your relationship.
protecting your relationship.
107
333891
3051
05:49
When you preserve
a separate part of your identity,
a separate part of your identity,
108
337534
3445
05:53
you're also leaving room
for your child to develop their own.
for your child to develop their own.
109
341003
3917
05:58
When a baby is born, so is a mother,
110
346295
3850
06:02
each unsteady in their own way.
111
350169
2809
06:05
Matrescence is profound,
112
353659
2237
06:07
but it's also hard,
113
355920
1768
06:09
and that's what makes it human.
114
357712
1851
06:12
Thank you.
115
360012
1155
06:13
(Applause)
116
361191
1769
ABOUT THE SPEAKER
Alexandra Sacks - Reproductive psychiatristAlexandra Sacks, M.D. is widely recognized as the leading clinical expert on matrescence: the developmental transition into motherhood.
Why you should listen
Alexandra Sacks has spent the last decade of her career helping women navigate their emotional lives as a reproductive psychiatrist. She is a regular contributor to the New York Times, and her work has been featured in TIME, NPR and throughout Asia, Europe and Latin America.
Board-certified in psychiatry with specialty fellowship training in women's mental health via New York Presbyterian Cornell and Columbia, Sacks helms a private practice in New York City and serves on the advisory boards for the American Psychoanalytic Association and the Columbia Psychoanalytic Center for Training and Research. In April 2019, Dr. Sacks will publish her first co-authored book, What No One Tells You: A Guide to Your Emotions from Pregnancy to Motherhood (Simon and Schuster).
Alexandra Sacks | Speaker | TED.com