Reframing “Mommy Brain”

by Alexandra Sacks, MD

A new mother finally gets her fussy baby to sleep and steps into a relaxing hot shower — with her glasses on. At a family barbecue she can’t recall the name of a relative she rarely sees.

It’s easy to laugh off such lapses as “mommy brain,” but there remains a cultural belief that pregnancy and child care impact a woman’s cognition and mental life, long after a baby is born.

Women have often chalked up these changes to hormones, fatigue and the intoxicating love for a new baby.

Hormones do affect cognition, and, as anyone who has ever done shift work or had jet lag knows, sleep deprivation saps our mental abilities.

And the current evidence in scientific literature suggests that pregnancy changes the brain on a physical, cellular level in ways that we are only beginning to understand.

However, there is no convincing scientific evidence that pregnancy causes an overall decline in cognitive performance or memory.

Instead, most experts believe that pregnant women’s brain changes are an example of neuroplasticity, the process in which the brain changes throughout life by reorganizing connections in response to the stimulation of new experiences, and neurogenesis, the process of growth that allows for new learning. A 2016 study in Nature Neuroscience found that even two years after pregnancy, women had gray matter brain changes in regions involved in social cognition or the ability to empathically understand what is going on in the mind of another person, to put yourself in their shoes.

It may be that some subtle aspects of memory are sacrificed to enhance other areas of cognition. A 2010 study in Psychoneuroendocrinology showed that pregnant women experienced some impairment in the ability to remember words, but did not show changes in other memory functions such as recognition or working memory. This means that these women might forget the name of a character in their favorite TV show, for example, but would have no trouble in the type of memory that involves learning, reasoning and comprehension.

One theory is that these changes may have an evolutionary benefit to strengthen the communication between a mother and her infant. They may improve a mother’s ability to help a child to first understand the outer world, and then learn how to make sense of internal sensations.

In keeping with evolution, animal studies show that the neural circuitry changes of pregnancy provide a crucial adaptation, thought to heighten a mother’s mental and emotional focus to this new and hugely dependent creature in her life. At the same time, as both neuroscience and psychological research on attachment theory suggest, a human mother’s brain enhances its empathetic capacities, strengthening a mother’s ability to pick up on a baby’s nonverbal communications through facial expressions and cries.

Of course, parents who do not go through pregnancy — including fathers, adoptive parents and L.G.B.T.Q. parents whose partners give birth — also experience psychological and physiological attachment, which some researchers have studied. But “daddy brain” is rarely discussed in a cultural or scientific context in association with cognitive decline.

Meanwhile, the cultural belief in “mommy brain” is so powerful that some studies have shown that pregnant women who walked into an experiment describing themselves as cognitively fuzzy were found in the lab to perform at a much higher level than what they reported. Were the cognitive changes just in their heads, or are our medical formulations missing something? In addition to the unscientific myths about hormonal women being best suited for the home and hearth, what else has propelled this broader misinterpretation about what “mommy brain” is and isn’t?

It’s not only the physiology of pregnancy that changes the brain, but also the lived experience of parenting. Brain scans cannot yet factor in all of the ways becoming a parent may change you, from the way you sleep to the way you exercise and even socialize. As Helena Rutherford, an assistant professor at the Yale Child Study Center said, “Individual differences factor into parental brain studies. Like other areas of psychology and neuroscience, there isn’t a one-size-fits-all approach.”

To have a full understanding of how pregnancy and motherhood affect women, we need to look not just at the brain, but also at the mind. The mind, like consciousness, arises out of our biology, but it is influenced by so much more than cells and signals: Our emotions, memories, relationships, even unconscious mental life also play a part.

“If we have learned anything,” the U.C.L.A. psychologist Martie Haselton writes in her book “Hormonal: The Hidden Intelligence of Hormones — How They Drive Desire, Shape Relationships, Influence Our Choices and Make Us Wiser,” it is that “although biology plays a role, our social context (and our agency to reflect and make choices) matters just as much.”

In 1956, decades before scientists started using M.R.I.s and functional neuroimaging to study changes in brain activity, the pediatrician and psychoanalyst Donald Winnicott published a paper on “Primary Maternal Preoccupation.” In it he described the intense psychological demands of taking care of a creature as helpless and dependent as a newborn, which requires new mothers to adapt their emotions and attention to zoom in on the baby.

Those improvements come with trade-offs, of course — an intensely narrowed focus means a blurrier periphery.

Many new parents describe the bandwidth demands of an emotional tug-of-war: They’re pulled in to take care for their babies, but at times also have to push away from that vortex to tend to their own emotions and other aspects of life that preceded and coexist with parenthood. This can be complicated by the guilt some parents describe feeling when they shift their attention to themselves and experiences other than the baby. And the psychological experience of mothers suffering from psychiatric conditions like postpartum depression presents additional complexity.

Then there are the cognitive and emotional demands of all of the learning that takes place in parenting. In addition to adjusting to a child’s rapid development, it is also psychologically demanding to make space for other relationships with your partner, family, co-workers and friends that have inevitably shifted with your new parenting role.

Learning also occurs in your remembering of your own parents’ behaviors as you re-enter a relationship you’ve been in before, but only from the child side.

Many women experience “mommy brain” as a deficiency, the lost ability to remember people’s names or keep their attention undivided while at work. But science reminds us that if we look at the changes without judgment we may find that they confer advantages. And to understand how data about brain changes impact real people’s lives, it’s important to consider the emotional life of the mind.

The writer Elizabeth Stone once wrote that the decision to have a child is “to decide forever to have your heart go walking around outside your body.” Perhaps it’s only fair that parenting necessarily requires some shifting in your mental space as well.

Alexandra Sacks is a psychiatrist and co-author of a forthcoming book about the emotions of pregnancy and the postpartum period.

SOURCE: The New York Times – 5/11/18

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