Through the depths and heights of darkness; mothers as patients in psychiatric care

This study attempts to deepen the understanding of health and suffering as experienced by patients who are mothers struggling with mental illness, and is a part of a larger research project. A mother’s relationship with her children is of vital importance for her experience of health and suffering. Women see themselves through their children and regard the child as an important part of themselves; hence, motherhood cannot be excluded from their experiences of health and suffering [1-3]. A recent study illuminated mothers’ struggle to reach their inner source of strength in order to become the mother they longed to be [2]. In interview studies [4, 5], mothers narrated about their struggle between the demands associated with mental illness and the responsibility for their children. The suffering caused by the illness was experienced as a power to which they felt forced to surrender. Mothers who suffered from eating disorders experienced guilt and shame related to motherhood [6, 7], while in a study by Montgomery [4], mothers described their mental illness as a struggle to maintain their maternal identity. They balanced between the vulnerability caused by the suffering and their strengths as mothers, making great efforts to camouflage their suffering. A study on women’s experiences of suffering connected to borderline personality disorders revealed that they longed for reconciliation [8]. They searched for meaning in life in order to create a genuine sense of self. When mothers had to relinquish their responsibility for mothering they considered that they had failed as a mother [4, 8, 9]. A study on mothers with postnatal depression indicated that they became overwhelmed by and disillusioned with motherhood, leading to anguish and despair when the difference between expectations and reality became too great [10]. Despite the burden of suffering and challenges in everyday life, mothers described their experiences of mothering as personal growth, which indicates that they can be both burdened and strengthened by their motherhood [11]. Previous research has revealed that the struggle between health and suffering promotes zest for life and personal growth [12-15]. Other studies have found that despite a range of practical and emotional difficulties, motherhood involved extremely positive experiences, which provide a purpose as well as fulfilment and meaning in life [5, 16]. There is a large amount of research on mothers during the perinatal period [17, 18], but not as much on mothers who struggle with health and suffering due to mental illness. ‘Mother and child’ is a traditional image of love and care between human beings, embodying existential and ontological hallmarks of vulnerability and responsibility [1, 2, 19, 20], hence the mothers’ experiences of health and suffering might reveal an underlying pattern of meaning beyond the obvious and visible [21-23]. Serious physical illness is often visible and its concequences for motherhood are quite obvious, while mental illness tends to be silent and invisible. Both can threaten life itself, confronting human beings with suffering in which they question their own existence and the meaning of life. This study strives to contribute to the knowledge of caring science and mental health care by means of a profound understanding of the patients’ existential world when being a mother in receipt of psychiatric care, with focus on inner processes such as health and suffering