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<p>Pregnancy and childbirth are considered one of the major life transitions, and as such they reflect a time of massive change and even transformation. This phase poses unique challenges to self-experience and identity and can be associated with problems of selfhood for the mother, leading, in some cases, to psychological or emotional disturbances, which can manifest as psychosis. Rather than seeing this psychosis as a collection of isolated and meaningless symptoms, this paper argues that experiences associated with these diagnoses are understandable developments of human subjectivity that relates to the whole peripartum (we therefore refer to peripartum psychosis instead of the more common denomination ‘postpartum psychosis’). We develop an account of peripartum psychosis through a novel integration of three sets of literature: (1) Three accounts of pregnancy and childbirth: one covers psychotic-like experiences without hospitalization, one covers normative (nonpsychotic) experiential alterations, and one covers psychotic experiences with hospitalization; (2) Feminist phenomenological literature studying the phenomenology of pregnancy, childbirth, motherhood, and breastfeeding; and (3) Phenomenological studies of <i>atmosphere</i>—the quasi-intentional intersubjective constitution and experience of affective qualities of the lived world. We suggest that peripartum psychosis involves the appearance of common and meaningful psychological processes involved in pregnancy, childbirth, and early motherhood, and that these processes are significantly impacted by the social and cultural atmospheres in which pregnancy and childbirth occur. This has implications for treatment and prevention of peripartum psychosis, as well as for our understanding of peripartum experiences more generally.</p>

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Radically Open and Profoundly Alone: Psychosis in the Peripartum

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  • 发表日期：

    2026年1月31日

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  • Elizabeth Pienkos,
  • Cynthia Dorrestijn

摘要

Pregnancy and childbirth are considered one of the major life transitions, and as such they reflect a time of massive change and even transformation. This phase poses unique challenges to self-experience and identity and can be associated with problems of selfhood for the mother, leading, in some cases, to psychological or emotional disturbances, which can manifest as psychosis. Rather than seeing this psychosis as a collection of isolated and meaningless symptoms, this paper argues that experiences associated with these diagnoses are understandable developments of human subjectivity that relates to the whole peripartum (we therefore refer to peripartum psychosis instead of the more common denomination ‘postpartum psychosis’). We develop an account of peripartum psychosis through a novel integration of three sets of literature: (1) Three accounts of pregnancy and childbirth: one covers psychotic-like experiences without hospitalization, one covers normative (nonpsychotic) experiential alterations, and one covers psychotic experiences with hospitalization; (2) Feminist phenomenological literature studying the phenomenology of pregnancy, childbirth, motherhood, and breastfeeding; and (3) Phenomenological studies of atmosphere—the quasi-intentional intersubjective constitution and experience of affective qualities of the lived world. We suggest that peripartum psychosis involves the appearance of common and meaningful psychological processes involved in pregnancy, childbirth, and early motherhood, and that these processes are significantly impacted by the social and cultural atmospheres in which pregnancy and childbirth occur. This has implications for treatment and prevention of peripartum psychosis, as well as for our understanding of peripartum experiences more generally.