Podcast Episode 92 - Strengths-based approach to maternal mental health
Interview with Amanda Stinton
I chat with Newborn Mothers educator Amanda Stinton from Our Fourth Trimester, who teaches the module on mental health in our Postpartum Education and Care Professional training. Together we discuss how we can take a strengths-based approach to support postpartum mothers and caregivers facing challenges. At the core of this conversation, we explore how to shift from a deficit-based approach to one that is respectful of people’s stories, honours their strengths and focuses on long-term solutions that build their capacity and trust in themselves.
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About Amanda
Amanda is a perinatal social worker, author and illustrator. Amanda has worked for almost two decades contributing to improved mental and emotional wellness for individuals and communities, in counselling, education and consulting roles.
After entering motherhood, Amanda founded her own private perinatal social work practice, Our Fourth Trimester, where she provides holistic parent-baby well-being consultations, preparing and planning for birth and the fourth trimester and ongoing support after birth.
We explore the following questions:
Why is it so important to have a strengths-based approach to postpartum mental health?
What actually is a strengths-based approach? Where did that idea come from and how did you come across it?
How would it look to work through someone’s challenge with a strength-based lens?
Why is it important to co-construct with mothers postpartum?
Can you share about the key concept of discovery and adaptation within the strengths-based approach?
What are the other elements of a strengths-based approach?
What’s that quote you share in the course about how postpartum will not always be a smooth ride, but it can be a huge time for growth and a great experience?
Additional resources we spoke about:
Our Fourth Trimester - https://www.ourfourthtrimester.com/
Newborn Mothers Podcast episode 23 - Suicide Prevention - https://www.newbornmothers.com/blog/episode-23-suicide-prevention
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Transcript
Julia Jones:
Hello and welcome to the Newborn Mothers Podcast. We've got Amanda on today who is our mental health educator inside our Postpartum Education and Care Professional training. Amanda is a perinatal social worker. She's an author and an illustrator, and she's worked for almost 20 years contributing to improved mental and emotional wellness.
I know that Amanda, we originally met because you were a student of mine, but then we kind of became closer because I really wanted to learn from you a little bit more about having suicide conversations, which is on another podcast episode. From there, the reason I got interested in learning more about suicide is because it is the leading cause of death for mothers in Australia. That was really shocking to me, and I felt like in my postpartum care work and in the training I'd done, I hadn't really learned a lot about mental health and I didn't really have very much literacy around mental health. I really wanted to make sure that that was included in what I was teaching because I feel like it's such an important part of mental health, sorry, such an important part of postpartum.
That brings us to what we want to talk about today, which is sadly, postpartum is often correlated with depression. We often do a little word association game. I say postpartum, you say depression. But it doesn't have to mean depression, but it isn't necessarily going to be easy or just happy. It's not a simple time in life. It's a big complex transition that involves identity and relationships and culture and sleep and eating, and all of the things that impact mental health are impacted by postpartum.
Why is it so important to have a strengths-based approach to postpartum mental health? (01:51)
Amanda, I'm really happy to have you in the new training, and I wanted to invite you on the podcast to have a chat. So do you want to add anything to your intro? Did I miss anything there?
Amanda Stinton:
Oh, no. Just I actually turned 40 this year. So to hear that 20 years was a bit sort of shocking. But I guess circling back to, I'm just really, really, really blessed to be part of your team now. Like you say, coming full circle from being a student, for anyone who's listening and they're starting out perhaps a career change or delving further into postpartum education and care work, it was six years ago that I had a little baby and did your course. It is just funny how the internet can be a beautiful place and a bit of a scary place, but our relationship has developed and now come onto your team.
We are both incredibly passionate about this work. I think that today some of the things that we're going to talk about the postpartum experience under the umbrella of mental health, it seems to be that in the first cohort of students that we've had through this course, something that is excited you and I both a lot is the thing that they've really latched onto is a strengths-based rather than a deficit-based to this developmental life stage. So like you said, I say postpartum, you say depression, hair loss, anxiety, all of these things. So if we are to be collectively a part of this renaissance in postpartum care, then yes, we need to look at ways in which we can look at this experience with a different lens then what our society is really used to, with that kind of deficit, pathologizing, let's fix these problems kind of lens. So I'm very excited that it's taking shape.
Julia Jones:
Yeah, it obviously took us a long time to figure out what do you include in one module about mental health, because it's such a huge topic. But when we were putting together the new postpartum training, it was really one of the most important things that I think we wanted to include was looking at things from a strength-based perspective. Because often for a new mum, it's a very black-and-white world where people are either saying, “oh, these are the best days of your life and you shouldn't be complaining about it”. Or they're saying like, “it's going to be terrible, you'll never sleep again” and there's not much in between that allows you to go like, "Look, this is amazing and it's also really hard, and I need someone to just be able to be in that gray area with me." I think that's what I really love about the strength-based approach, it doesn't dismiss the challenges, but it also builds resilience and it builds as professionals, our belief in our clients that they are capable of dealing with these challenges.
Amanda Stinton:
I think it's certainly, it's a shift. I think that if we are to practice what we preach, even though as you have said, 20 years or so I've been doing this kind of work, is that we are to borrow from a previous colleague of mine a little saying that he said, “We are all practicing our greatness”. You don't just kind wake up in the morning and you're this great kind of professional, everything that you do is a practice and to kind of be gentle on yourself. I think that if we live in a society which sort of fundamentally is still unfortunately viewing this time through that kind of deficit approach, then we are going to stumble and fall down sometimes and sometimes you do, your first instinct can be to jump into that fixing, how do I fix this problem kind of thing.
Rather than feeling this pressure to have all of the answers, it's actually really helpful to take a step back and actually, yes, look at the frameworks which support our practice and look at the philosophies that we have and the answers are actually in there rather than narrowing in on these specifics. If it's a breastfeeding challenge, "Oh my goodness." And it's a very heightened, everyone kind of gets very heightened about it, or if it's a mental health challenge, "Oh my goodness, we've got to fix this, fix this." But if we kind of step back and just really embrace these fundamental beliefs that we have about the world and the way in which we want to change the world to look and feel like a better place, then you can kind of work from there.
What actually is a strengths-based approach? Where did that idea come from and how did you come across it? (07:33)
Julia Jones:
Yeah, I love it. Can you rewind a little bit because some people were listening to this going, what actually is strengths-based? They don't know what that means, so where did that idea come from, how did you come across it?
Amanda Stinton:
Goodness, you put me on the spot there, in terms of the actual origins, I'm not 100% sure, but as a social worker, as a profession, a strengths-based practice is very much fundamental to the way in which we work. Whether you're a social worker working one-on-one with clients, whether you're working in research, whether you're looking at policy, it doesn't matter.
But I think that for me, I came across it, in Australia there is a bit of a bible, a book which we refer to throughout the modules called The Strengths Approach by Wayne McCashen. It's really a bit of an Australian social worker go-to to conceptualize.It sounds a bit airy-fairy, doesn't it? In terms of a mental health helper approach, when you think about psychologists and counselors and social workers and all these kinds of people that work in this space, sometimes a strengths-based approach can be a bit dismissed of like, "Oh, yes, yes, we all understand that people have strengths." But then there can be all these other modalities that different people can apply, which do narrow in a little bit more on the problem. There's actually a lot that's the strengths-based approach has to offer.
In that very long-winded, it didn't really answer much there, but one of the ways in which I find it can be helpful to describe and explain something is to do a compare and contrast. So if we think about the context of postpartum, and we've already kind of chatted a little bit about this idea of it being pathologized and that word association of negative things, some of the key things that are involved in a pathologizing approach is that we are looking at the deficits rather than the positives. We are trying to solve problems and understand what it is that's wrong and come up with solutions that are usually fairly short-term. We see there's a significant need and that need needs to be met, about predicting and controlling the outcomes of what's going on, overcoming weaknesses, so rather than a focus on strengths, we are looking at what is wrong and how do we fix that? How do we diagnose? If somebody's in a crisis, we all kind of go into this reactionary fix mode.
Another element of the deficit-based or pathologizing approach to issues that occur throughout the lifespan, including mental health difficulties, is that there's a punishment of non-compliance. So if you've got a problem, you look outward to an expert, they give you the tools, and if for whatever reason you don't comply with the recommendations, there's this kind of air of punishing non-compliance.
Julia Jones:
Something I see so commonly in postpartum with things like breastfeeding advice or sleep advice, and it's kind of like, "Well, you didn't do what you were told so well, you deserve to not sleep." Or "Of course your nipples are hurting, you didn't do what I said you should do."
Amanda Stinton:
It's very much isn't that, and we think about, so why is that happening? Well, there's a narrowing in on the focus. So if we just take nipple pain, for example, I guess that's a result of a whole range of complex things that are going on, it's not just one thing, "Oh, you've got nipple pain, put this cream on." There's a whole range of things that we need to step back and look at in context.
As people, as a society that is very much dominated by a culture that is about gathering information, learning, fixing, doing, if we don't follow the A, B, C steps, there's a sense that from the individual that, and sometimes this can be an internalized thing, it's not necessarily that a professional doesn't necessarily punish the non-compliance and say, "You did this..." But internally, a person can kind of go, "Well, I didn't actually follow that advice to the T, so that's probably where I've fallen down."
Very, very common and I'm sure that as people are listening, they can come up with either their own and/or experience from other people that they've worked with or that they know and kind of go, "Yes, this is resonating. This sounds like a situation that we are dealing with on a day-to-day basis."
How would it look to work through someone’s challenge with a strength-based lens? (13:27)
Julia Jones:
So a lot of people would never even have heard of a strengths-based or deficit-based approach, but I think our default in our society is a deficit-based approach, even if we don't realize that's what we're doing. So I think it's a really powerful thing to shine the light on and make it really explicit that you could actually approach things in a different way. So how would that look? Yeah, how would that, if someone comes to you with a challenge and you work through it with a strength-based lens?
Amanda Stinton:
If we kind of flip the script a little bit and think, okay, well maybe we don't have to default to this pressure that we feel both as mothers and parents who are seeking the fixes to the problems, but also as professionals who feel like, “oh, I've got this professional hat on, I am seen as the expert, I must intervene and fix this”. So how do we flip that script that it is not working right? There are lots and lots of issues with it, and when we do flip the script, we see really great outcomes. So in contrast, rather than looking at what's not working, we start from a place of, okay, well what is actually working?
So if we take the example that you gave of someone dealing with really painful nipple damage, for example, it's very easy to focus on, okay, well that's not working, but take a step back and look at, okay, what is? Let's look at this breastfeeding journey in its entirety and look at the challenges that perhaps have been overcome to already get to whatever point they're at.
If we start from looking at strengths, then that's a really valuable place to start from, because if you think about yourself, if all we're focusing in on is the deficits and what's not working, then it doesn't really inspire you to take action to make things better. But if we can kind of say, "Oh, yes, you've got a lot of pain, but there was those first couple of days where things were going really well, let's look at the way that the fit and hold is occurring between the mother baby dyad. You had those days where things were going really well, we can get back there again, what did that kind of look like?"
I suppose that example is co-constructing. So rather than problem solving, coming in with that expert hat is actually working together on a solution. That's something that again, in our society that pathologizes and seeks out expert advice that's not actually really a very common practice. So it takes a bit to kind of break away from that script and actually stop and go, "Let's work on this together. Hey, I actually don't have all the answers." And as you know, Julia, I always say to you, I'm not an expert. I'm not an expert. I say that to people I work with all the time, but I think I do have skills in listening and trying to understand and just being really interested and curious about somebody's experiences. I think that that is the key to working together to find solutions.
Why is it important to co-construct with mothers postpartum? (17:13)
Julia Jones:
Yeah, I love that. Without having any training or understanding of that myself, that was definitely always the kind Newborn Mother's approach that we would ask people, "How does that feel for you? And what did you think of that advice? And is it working?" And we'd be constantly just reminding people to check in with themselves, “would you like to try something different? Should we explore some other options?” And those were always my go-to questions. I didn't know at the time that that is co-constructing.
Amanda Stinton:
Yeah.
Julia Jones:
It makes so much sense why when I was putting together this new course, and I knew I wanted to have this mental health module, and I was thinking, who can teach it? And I knew it had to be a social worker, and now I know why.
Amanda Stinton:
Yeah, and I think that this concept of the mother or the parent as expert is something that is often paid a lot of lip surface to, so you'll often throw away lines of like, "Oh, you just trust your instinct and intuition, you know best." That can kind of be said, but then if the actions to follow that are like expert hat, fixing, you're doing it wrong, let's shift things around, then yeah, that's all it is lip surface, but this idea of co-constructing, because you and I are mothers and we've both felt we can empathize with this. People say you're an expert, but you really don't feel it. People say, "Oh, you know your baby best." And you're just there kind of going, "I've got no idea what I'm doing." But if you've got that person walking alongside of you co-constructing, working together, then that builds up. It allows those instincts and intuition to come to the fore because they're in an environment in which they can flourish.
Julia Jones:
Yeah, I think that's really true. Actually sometimes saying to someone, "You know best" is really not helpful because often that's not how a mum feels. Mum often feels really overwhelmed and confused. But co-constructing, isn't just saying, "Just trust your gut." It's actually working with someone to help them to figure out what has worked in the past, what resources they can draw on, and what ideas they might have for creative suggestions that they could try. Also celebrating that success saying, "Well, remember last week when you were really overwhelmed about this and now you've got the hang of it and that's easy for you."
Can you share about the key concept of discovery and adaptation within the strengths-based approach? (20:08)
Amanda Stinton:
It does. It really bolsters these kinds of what can be unfortunately airy-fairy concepts of listen to your instincts, trust your intuition. So as we work down in the line of what are these key concepts behind a strengths-based approach, there is this idea that it's about discovery and adaptation.
For me, as somebody who switched from, previously I was working with adolescents for majority of my career. It wasn't until I had my own baby that I switched to working with parents and babies, is that I was like, "Oh, wow" - this concept of discovering and adapting in the context of what we know about the postpartum period, what you know when you do your course, Julia, and really kind of delve into the intricacies of what is happening at a biological, hormonal, societal level and I suppose the concept of matrescence, it is about discovering and adapting. How exciting to be working with somebody at a point in their lives where so much, if you get that support and discover things and adapt to things in that really supportive way, then that is going to have flow on effects throughout your entire life.
If the postpartum period is all about discovering and adapting, how lovely that a key concept of the strengths-based approach is all about discovering and adapting. It makes so much sense as you just described a little bit earlier, that I was already doing this stuff and now I know where it fits into a framework.
What are the other elements of a strengths-based approach? (22:25)
Julia Jones:
Yeah, I love it. Just carry on down the list, because I think we haven't quite gotten through all of the kind of strength-based approaches. So yeah, let's talk a little bit more about those last couple.
Amanda Stinton:
Yeah, so emphasizing possibilities rather than overcoming weaknesses. So there are so many possibilities. It is really a case of choose your own adventure, which can be a little bit scary, but that is very much what we are supporting people to do. And sorry, as I just lose my concentration a little bit, Julia, because as you well know, there is a house being renovated next to us and they've just started up at an excavator.
Julia Jones:
We can't hear it, so don't worry about us.
Amanda Stinton:
Sustainable solutions, so in contrast to this, what is common in a deficit-based approach of short-term solutions, it makes sense, doesn't it? That if we are in a, how do we fix this problem, how do we respond to this crisis that the solutions which are prioritized are those short term. Whereas from a strengths-based approach, we just go, "Let's cool our jets a little bit." It's easy to jump into this crisis mode of all things are going terrible, this is just leading down a terrible path, and just kind of step back and go, "People are amazing. They have these amazing strengths and abilities inside of them, and let's actually look at sustainable solutions."
Julia Jones:
Yeah, I love that because that's really common in postpartum too, that often the advice people are given is someone will try it for a week and go, "Well, that was exhausting. There's no way I can do that in the long term."
Amanda Stinton:
Exactly, yeah. Then I guess the danger is that they don't seek out that if that's how you conceptualize what support looks like…
Julia Jones:
They're not going to ask again.
Amanda Stinton:
You tried, it doesn't work, well, then it doesn't really encourage you to continue looking for support.
Julia Jones:
It also makes mums feel like a bit of a failure, because they're like, "Well, it's because I'm not doing it right."
Amanda Stinton:
Yeah.
Julia Jones:
Or, "I wasn't consistent enough." Or something.
Amanda Stinton:
I guess just to round out the last two points that I have is looking at opportunities. So again, a little bit like those, if we are looking at emphasizing possibilities, there are amazing opportunities that exist and celebrating successes, because again, if we compare and contrast that with punishing non-compliance, which is what tends to happen, but we don't very often get that positive feedback. Perhaps I'm thinking out loud as I say that one of the big problems in regards to why don't we celebrate the successes is the kind of closed off nature in which we are doing early parenting, in that we are very much doing it on our own, and there's not really anyone to celebrate the successes with.
That's what a strengths-based approach looks like, and it's not an airy-fairy, oh yeah, that all sounds well and good, but there are problems that we need to fix. If we consider it as a framework for practice, and if we consider it as a philosophy for practice and work from there out, then we're going to really be minimizing that danger of just falling into that predictable deficit-based approach, which is unfortunately so common.
What’s that quote you shared in the course about how postpartum will not always be a smooth ride, but it can be a huge time for growth and a great experience? (26:23)
Julia Jones:
Yeah, I love it. Let's wrap up there. The last thing I want to hear from you is you had a great quote from acceptance and commitment therapy, which in the course we talk about a lot of different, I mean, this is part of that opportunity, isn't it? But knowing that there's a lot of different things that people can do to improve their mental health, supporting them to find the right professionals and the right resources and that sort of thing.
But overall, that's not to say that postpartum will always be a smooth ride, and I don't think we should expect it to be easy. Absolutely, it can be rewarding, and it can be a huge time for growth and a great experience, and you can love motherhood very much and still find it really challenging. So yeah, what's that quote that you had?
Amanda Stinton:
Yeah, so sometimes there are those quotes and there are many that belong to you or that you have shared that resonate with not just me, but I'm sure to many people listening today and when you come across them, you're like, "Yes." For me, this was certainly from acceptance and commitment therapy, one which really resonates really well is that so often we hear, don't we, this polarizing kind of views either everything is great or everything is terrible, whereas wouldn't it be more helpful to conceptualize the experience of postpartum and in fact the experience of life more broadly as, “Living a rich, full and meaningful life amidst all of life's challenges”?
Julia Jones:
I love it. I love it. It's so important that we really reframe the whole way that we approach postpartum, and I think I'm really glad to have these perspectives as part of our new course. Do you have any last thoughts, Amanda, before we wrap up?
Amanda Stinton:
I guess wrapping up, for me personally and for anybody who's listening and thinking about these concepts that we've been discussing from a personal and professional standpoint, I just think it's really, really lovely to have this opportunity to talk with you today and appreciate how far I have personally come in my journey, thinking about those very early days of having a young baby and thinking about my practice and thinking, I think I really want to pivot to a different area. I think that I could have very easily fallen down any kind of a rabbit hole, right? If you wanted support, there are so many ways in which you can go about doing it, but for whatever reason, I fell into your kind of rabbit hole and haven't looked back and I really think that it's just been a really great journey and one that I'm looking forward to continuing alongside you and your team.
Julia Jones:
Lovely to have you on, Amanda, and it's been great for me to learn more about mental health from you. I'm sure a lot of our students have really enjoyed that as well. If anyone wants to go back and listen to the lesson on having conversations about suicide, that is episode 23, and if anyone's interested in joining the course, they can go to newbornmothers.com/training and learn all about the curriculum and how to enroll there. Thank you so much, Amanda.
Amanda Stinton:
Thanks for having me.
