74 Grief and Loss Across the Lifespan
significant other is always a challenge. Even so, these are all part of entering
adulthood, confronting life’s ambiguities, celebrating a child’s increasing
autonomy and burgeoning identity, and learning how to balance one’s own
needs with the needs of loved ones.Maternal Depression and Early Infant Development: Risks for
Relational Deprivation and Loss
Janet Shapiro
Janet Shapiro is a professor at Bryn Mawr College Graduate School of Social Work and
Social Research. She is director of the Center for Child and Family Wellbeing and was an
early social work pioneer in understanding the neurobiology of attachment and infancy.Maternal depression can lead to experiences of relational disruption and loss
in caregiving environment of infants and young children. The Center on the
Developing Child at Harvard University (2009) estimated that 10% to 20% of
mothers will experience depression during the first year of their child’s life and
the incidence rate is higher for women experiencing a range of other psycho-
social stressors. Thus, assessment and intervention with mothers experiencing
depression either prenatally or postpartum are important areas of practice and
in particular, for psychosocially vulnerable families.
For developing infants, relationships with primary caregivers are a
primary “active ingredient” in the well-being of infants and young children
(National Scientific Council on the Developing Child, 2007). Research on attach-
ment has long shown that the quality of parent-infant attachment is related
to multiple developmental competencies that emerge over time (Ainsworth,
et al., 1978). For the developing infant, a “secure” attachment is supported
by ongoing experience with emotionally available and empathically attuned
caregivers who are able to care for the infant in ways that support positive
developmental outcomes and emerging indicators of infant mental health
(Schore, 2001). The developmental benefit of a “secure” attachment relation-
ship becomes evident over time in the developing child’s capacity to expe-
rience and regulate a range of affect, to form relationships infused with an
expectation of trust and felt security, and an ability to develop age- appropriate
capacities for self-understanding and understanding of others (Siegel, 2012).
Recent research in the cognitive neurosciences provides an additional lens
on the importance of early caregiving relationships by describing how the
quality of early interactions affects brain development and, in particular, the
developing child’s stress-response system, which is critical to their long-term
health and well-being and capacity to sustain resilience in the face of stress
and adversity (Gunnar, 2000).
For many families, pregnancy and early parenthood is a time of tremendous
stress in ways that can impede even a well-intentioned caregiver’s capacity to
foster secure attachment and the child’s experience of feeling “ psychologically
held.” Lack of access to consistent and empathically attuned relational care
constitutes deprivation for the infant and young child because it poses great
risk to their developmental well-being.