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The foreword to this book begins with a quotation by Hodding Carter: 'A wise woman once said to me: "There are only two lasting bequests we can hope to give our children. One of these is roots; the other, wings."' It is sadly apparent that the mothers of the women interviewed for Susan Nathiel's thoughtful and approachable study, were unable to give either of these things to their daughters. Their illnesses rendered them barely able to look after themselves.
The author begins by giving the reader background information on infant development, and the importance of bonding between a baby and her primary caregiver. Interestingly, Nathiel defines 'maternal' as referring to the primary caregiver, whether male or female, parent or other relative or guardian, but the focus of the study is the failure of the mother's ability to parent.
She then takes us through early and middle childhood, adolescence, young adulthood and adulthood, outlining the aspects of development taking place in each time period, and what can go wrong for the daughter when the mother is mentally ill and unable to give adequate care. A crucial area of research comes from Allan N. Schore on infant neurological development, who found that 'brains are primarily social organs, and they develop in some very different ways, depending on the context in which they live'. As the baby's brain determines how to respond to the world, the world determines to some degree how the brain will develop. The world is 'the instruction manual' for the infant's brain/mind. And of course 'the world' for an infant is the primary caregiver, so if that relationship is fractured, the infant's development is compromised. Schore refers to our 'implicit sense of self' which is built up from every moment of experience we have, and all before we have real 'event' memory. Our 'deepest and most troublesome feelings' come from this very early time in our development.
Nathiel discusses the research on 'bonds and brains', referencing John Bowlby and attachment theory, as well as more recent studies. A 'secure base' with a consistent mother produces securely attached children, whereas insecurity and an inconsistent mother produces preoccupied and anxiously attached children. A mother who is rejecting produces insecurity and avoidance. A child has nowhere to go when the source of comfort and safety is also the source of danger and threat.
All this sounds straightforward, but translating it into real life with the 'daughters of madness' and their lifestories shows just how devastating the effects of mental illness in a parent can be. Two of the women interviewed had mothers with a personality disorder who undermined everything they saw in their daughters, criticizing and demeaning them constantly, but keeping a public persona of sweetness and light. Their daughters suffered particularly badly. Other women had mothers with depression who were the opposite of the controlling personality-disordered parents, being often detached from their daughters, and the family generally. Nathiel points out the factors that made for a better outcome for these women, and one of the most important was the availability of at least one supportive adult in their lives when they were growing up. Explanations of what was wrong with their mother would also have made a big difference, as would have better care from mental health facilities.
Some of the responsibilities heaped upon these women when they were children or teenagers are extraordinary. June, whose mother had schizophrenia and multiple personality disorder, recalled having to take her floridly psychotic mother home from the psychiatrist's office to wait for a hospital bed, and being told 'to keep a watch on her, remove all the knives, put sheets over the mirrors so she can't see herself, because that would set her off. And of course, make sure she doesn't kill herself, or kill anybody else.' June was thirteen and her sister fifteen at the time.
The author admirably encompasses a broad range of concerns with her interviewees, and presents their stories in interesting and useful extracts. She discusses the influence of the women's fathers, the effects on their siblings, and the ongoing reverberations of their dysfunctional family life on their adult decisions such as marriage and parenthood. I appreciated the chapter headed 'Afterthoughts' and the section where she asks the women about the best as well as the worst aspects of having a mentally ill mother. This gave some attention to the fact that these women's mothers were seriously ill and unable to care for their daughters adequately because of this; they were not necessarily wilfully cruel or negligent.
Any book that helps us to understand the experiences of the mentally ill and their families is welcome, and Nathiel's is no exception. She has produced a useful study which is well written with clearly presented information that is accessible to mental health practitioners as well as those with mental health problems, their families and other caregivers.
© 2008 Sue Bond
Sue Bond has degrees in medicine and literature and a Master of Arts in Creative Writing. She reviews for online and print publications. She lives in Queensland, Australia