I am changing my daughter’s diaper. She smiles, and she looks at me. I smile, too, closing the diaper. I decide to kiss her small and soft feet, playing with and tickling her. She laughs and… At one point, I have an intrusive image of me biting her feet with strength. I see her crying and having the face red. I can see the blood on her feet… It is a thought that I had, and I have too in the present. I imagine myself losing control and harming my ten-month-old daughter.
The previous situation is an example of violent intrusive thoughts that are typical of postpartum OCD. What is it? It is a type of OCD characterized by scary obsessions related to harming a newborn infant (ideas of accidental harm or intentionally harming the newborn) and compulsions to reduce the anxiety related to these obsessions.
Postpartum OCD may begin during pregnancy or a few days after the delivery, and 30-40 % of mothers may suffer. Fathers could be affected too, although there is less data about Postpartum OCD in fathers than in mothers. Some examples of obsessions are: “My baby could die in her sleep”; “I could put my son in the microwave”; or “I could hit my son in the soft spot in his head.” Additionally, people suffering from postpartum OCD may have intrusive images of the baby choking and not being able to save it, stabbing the baby, or drowning the baby during a bath.
Examples of compulsions may include repetitively checking on the baby to see if he/she is still alive while sleeping; mental compulsions such as praying; avoiding be alone with the child or holding the baby in a particular way; or asking the partner or relatives for reassurance. The sufferers are terrified of committing harm, and they may attempt to resist their obsessive thoughts or neutralize them with some other ideas or behaviors. Parents with this type of OCD are also upset because they report that these obsessions are against their personality traits and personal values. There are not clear ideas about the causes, but it seems that parents with Postpartum OCD have high sensitivity to a sense of guilt/ being responsible due to childhood experiences.
The best treatment for Postpartum OCD is ERP (exposure and response prevention) and SSRIs. The best way to learn how to practice exposures is by contacting a psychologist. The sufferers should practice exposure, try not to check if the baby is sleeping or not, or try to be alone and feed the baby even though it could be scary.
1Abramowitz, J. S., Schwartz, S. A., Moore, K. M., & Luenzmann, K. R. (2003). Obsessive-compulsive symptoms in pregnancy and the puerperium: A review of the literature. Journal of anxiety disorders, 17(4), 461-478.