Love Works Like This

In her third or fourth memoir, depending on how you count, psychologist Lauren Slater tells the latest twist to her story of living with mental illness, with a record of her pregnancy and the birth of her baby Eva.  Slater starts out with great ambivalence and is not at all sure that she wants to be a mother.  But she goes off her psychiatric medication because she reads that it could cause defects in her child, and she wants to avoid that.  Soon she finds her old depression returning, and she fears that she will have to be hospitalized, and with considerable dread and worry, she starts up with her medication again, taking lithium, high doses of Prozac, and an anti-anxiety drug, Klonopin.  She worries also about her marriage and her career, and her whole pregnancy is a trial for her.  Even her birth is difficult, finally ending with a caesarian section.  But, as we might expect, once her daughter is born, Slater starts to bond strongly with her, and the book ends on a positive note. 

Slater's previous books are Welcome to My Country, Prozac Diary, and Lying.  She is one of the most thought-provoking and skillful memoirists of mental illness, and Love Works Like This does not disappoint.  Slater shows how there is little information available about the safety of psychiatric medications for pregnant women, and how difficult it is for a pregnant woman to decide how to weigh the welfare of the fetus against protecting her own sanity.  She writes with humor and compassion, peppered with a good dose of outrage at the way she is treated by other health care professionals and the assumptions that other people make about her role as a mother. 

The central question preoccupying Slater in this memoir is whether a woman with a chronic mental illness should be a mother.  The question is not so much whether it is responsible to take the risk of having a child with an enhanced genetic risk of having a mental illness.  Rather, the question is whether it is fair to the child when there is a real danger that the illness may cause the woman to be a bad mother, unable to care for her child.  The issue is especially powerful for Slater because of her experience of her own troubled and difficult mother, who she hints may indeed have added to many of Slater's own emotional problems.  Readers of Kay Redfield Jamison's An Unquiet Mind (reviewed in Metapsychology November 1999) will remember when Jamison reports her anger at the assumption of other people that, as a woman with manic depression, she should never choose to have children.  Slater takes her own question seriously and even has doubts over the wisdom of having a child; she is painfully aware of the risks in becoming a mother and it is important to her that her husband would be able to care for their child should she herself be debilitated by her illness.  But her central point is hopeful; she has confidence not just in the power of psychiatry to make mental illness manageable, but also in the power of love to sustain her relationships through whatever difficulties she may face. 

© 2004 Christian Perring. All rights reserved.

Christian Perring, Ph.D., is Academic Chair of the Arts & Humanities Division and Chair of the Philosophy Department at Dowling College, Long Island. He is also editor of Metapsychology Online Review.  His main research is on philosophical issues in medicine, psychiatry and psychology.