Post-partum blues: A marker for intersubjective bonds

In spite of the growing interest in post-partum blues in the scientific literature, this phenomenon remains loosely defined at the clinical and nosographic levels. Our objective has been to establish more precise clinical contours by comparing women going through such a state with others not suffering from post-partum blues, and to specify the differences, if they exist, in mother-baby interactions of each group and their consequences on the early development of the child. The longitudinal study from birth till the age of two months concerned twenty-two mother-baby dyads. Our results reveal two distinct groups of women suffering from the blues: mothers with “ordinary” blues, corresponding to the usual descriptions, and mothers with “sad” blues, who are not sick enough to qualify as being clinically depressed. Post-natal blues thus seem to indicate psychic work contributing to the internal elaboration of the “birth event”; their absence, or their exclusively sad style indicate a fragility of the protective shield and of the mother’s containing ability. More importantly, we show that some early abilities of the newborn, particularly the organization of the hand-mouth reflex according to Brazelton’s clinical check-list, are exclusively visible in mothers presenting ordinary blues. This acquisition of a self-comforting ability by the baby constitutes a particular organizing and coordinating ability both at the psychomotor and the tonic postural levels, but it is the association between this capacity and some psychic mothering qualities that are a new discovery. Pinpointing this ability makes it possible to show the early dimension of emotional exchange between the mother and the child, probably already present during intrauterine life. Finally, in our population, the presence of an ordinary type of blues and a hand-mouth reflex immediately after birth was a guarantee that mother-baby interactions at the age of eight weeks would be adjusted and attuned. On the other hand, mother-baby exchanges at two months were marked by disharmony in the case of sad blues and the absence of hand-mouth ability as measured by Brazelton. The blues could thus constitute a marker of the intersubjective mother-baby bond in the neuropsychomotor evolution of the child.