Mothering Mothers

Source: Suniya Luthar

The notion that grown, highly competent career mothers need ongoing mothering themselves may seem odd, but without question, it is true. Research on resilience has shown that if a mother is to be an effective parent to her children, she must receive ongoing replenishment herself, especially when under high daily stress.

And well-educated mothers can be a group at especially high risk for stress, for a number of reasons. To begin with, demographic data show that over time, there have been greater increases in the hours that well-educated US women spend on children’s care and activities, than parallel increases among both highly educated fathers, and less well educated mothers. This is a group of women who tend to be stretched very thin.

Second, high intelligence can be a mixed blessing for psychological well-being. It certainly does bring good problem solving skills. At the same time, high verbal intelligence is often linked with high tendencies to ruminate and worry.

Finally, there is the contagion of family stress. In general, well-educated moms (like others) tend to be not only primary caregivers for their children but also provide care to other adults, including elderly parents and partners. That is a lot of tending to be putting out, and leads to the question we’ve asked in our research with this demographic of women -- Who mothers mommy? For too many, the answer is nobody, at least not on a regular basis.

Tending the caregivers: Support groups for physician mothers

Recognizing that mothers, like their children, must “have a village”, we set about creating a close-knit support network for working moms, and recently tested the intervention with health care providers who are mothers. These were women working at a premier health care facility in the US, the Mayo Clinic, in Arizona.

Why work with this set of moms? Because beyond the previously noted risks for well-educated women in general, these mothers are at very high risk for burnout. Studies have shown, for example, that physicians are at higher risk for depression and suicide than are people in the general population. This risk is more pronounced among women physicians than men, and still more so among those who are mothers.

So we brought a three-month program, involving weekly one hour group sessions, to the Mayo Clinic in Arizona, and hospital administrators gave one hour of freed time to those who signed up for the study. Half of these women were assigned to weekly "Authentic Connections Groups", and the other half used their one hour of freed time per week as they chose for three months.

The results of this intervention were heartening at many levels.

To begin with, there were zero drop-outs across the three months. Freed time did not, of course, imply that attendance at weekly groups was mandatory, yet all enrolled women participated through the end.

Additionally, research assessments showed major improvements across psychological and biological measures. As compared to the Control group (one hour of freed time), women in the Authentic Connections program showed greater improvements on depression and overall distress at the end of three months. What’s more, relative gains were still more pronounced three months after the program ended. Follow-up assessments showed group differences not only on depression and distress, but also on all other central variables including parenting stress, self-compassion, feeling loved, and physical affection. Program participants also showed more reductions in cortisol levels (a biochemical indicator of stress) than control moms after the intervention and at a three-month follow-up.

Why such positive results? Foremost, because at its core, the central goal of ACG was to promote the development of close, mutually supportive relationships among these highly stressed, overscheduled moms. Just as children need to receive unconditional acceptance, so do their mothers, who are charged with providing it continually and across a period of decades.

Thus, In the ACG program, we deliberately focused on developing and strengthening what we called “go-to committees” for each woman: at least two adults (not their spouses or partners) with whom they generally felt close and safe. As topics were shared in the weekly group sessions over time, the moms each also shared them with their respective go-to’s. Over time, therefore, groups provided comfort, solace and advice as needed, building what participants described variously as a ‘blanket of love’, or a ‘secret sisterhood’ with shared experiences and genuineness in the relationships. In short, by the end of the three-month program, each woman had developed great closeness not just with other moms in their work setting, but also with at least two or three other women in their personal lives.

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Supporting caregivers across diverse everyday settings

Interestingly, the ACG program had its roots in a similar intervention previously developed with women at the opposite extreme of the socioeconomic spectrum: low income women, who were in treatment for heroin addiction. As with ACG, their groups were offered in a setting where they were present in their everyday lives, in this case, their methadone clinics. And at the end of the intervention, results confirmed significant benefits not only on depression and distress but also on parenting behaviors.

Since completion of the Mayo project last year, we have successfully run the ACG program with various other adults in high stress-settings, including military vets, graduate students, and women in STEM disciplines, and are now working with teachers in high-achieving schools. In all cases, groups are provided in these caregiving adults’ everyday community settings, including their workplaces, local clinics, and school settings.

Increasingly, US workplaces are emphasizing wellness programs, and with the positive results published on ACG, we hope to use this approach widely in the future. Stress at work causes enormous expenditures, and the costs of this program are miniscule compared to the potentially averted losses from stress-related absenteeism and job turnover among highly trained and skilled professionals, such as health care providers or educators. And freeing this one hour per week during employees’ regular workdays, with groups provided on the premises as was done at Mayo, will be critical for the success of the program given how packed the professionals’ schedules tend to be.

Besides cost-savings to their organizations, there are major benefits of such interventions for the next generation. Children’s relationships with their major caregivers are fundamental for their resilience, and an unhappy, exhausted mom simply cannot sustain “good-enough parenting” for any length of time.

Finally (and perhaps most importantly), ensuring such support is critical for the personal well-being of the women themselves. Too often, moms put their own needs on the back-burner, after attending to sundry demands at work and at home. It simply makes sense that those who serve as first responders and offer so much tending for many others, must themselves be tended – with this happening on a reliable and ongoing basis.

So, let’s make this a priority. Let’s start to ensure that moms receive mothering themselves, and that this is done regularly.

Happy Mother’s Day!