A few months after the birth of her daughter, 16-year-old Rachel Wolfley got an explanation from her doctor about why she was lying in bed all day instead of doing things with her baby — she had postpartum depression.
That’s what brought her to the attention of Kent Youth and Family Services and counselor CJ Ellsworth.
Ellsworth asked Rachel how her 3-month-old daughter, Annabelle, was doing and learned that the girl was a fussy, stressed-out baby who had trouble sleeping.
She figured the problems were related, making both mother and daughter a good fit for the agency’s infant mental-health counseling program.
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Ellsworth considers Rachel, now 19, and Annabelle, who turned 3 last month, a success story for the agency, one of a dozen supported by The Seattle Times Fund For The Needy.
The idea that infants and toddlers have complex minds that are susceptible to the same kinds of mental-health problems as adults — such as anxiety, depression and post-traumatic stress disorder — has taken decades to mature into practical therapy, which is not always easy to explain to the general public.
“The first thing that someone will say when they find out that I work with babies and mental-health therapy is, ‘So what do you do, like, have them laying on a couch?’ ” Ellsworth said.
There’s no couch.
“When you walk into one of my sessions, there is usually a blanket and a mess of baby toys on the floor,” Ellsworth said, noting that while babies can’t articulate what they’re feeling, they show it in how they play and how they relate to the most important person in their lives.
Children are born to venture forth across the blanket and try different toys, but if things get a little scary or frustrating, they rush back to a parent for reassuring hugs and kisses. Then they’re off again.
With each cycle, the parent-child bond strengthens, enabling children to explore further and learn more confidently about the world around them and the people who live in it.
“It’s their springboard for the rest of their relationships,” Ellsworth said.
But if parents are too stressed or distracted by their own problems to be that secure home base, the bond is weakened, with far-reaching consequences for emotional and social development.
A difficult start
In 2009, the agency began developing its own mental-health counseling for infants and children up to 5 years old. The effort evolved out of a similar, voluntary program for parents trying to regain custody of their infants and toddlers through King County Juvenile Court.
Ellsworth, who manages the Infant & Early Childhood Mental Health program, typically works with single parents, parents who have temporarily lost custody of their children because of neglect or abuse, and sometimes foster caregivers when it’s not possible to include the birthparents.
Rachel Wolfley was finishing her sophomore year at Highline High School in 2010 when she realized she was about six months pregnant. She didn’t tell her mother, MaryAnn Bredl, until that October, about 10 days before the baby’s due date.
Rachel had had no prenatal care. and the birth was complicated. Doctors had to break the baby’s clavicle to deliver her.
Annabelle recovered from that, but she was fussy and didn’t sleep well.
Rachel, on the other hand, slept too much. She was afraid to go back to school, where some classmates, even friends, had said hurtful things about her. She didn’t have much energy for Annabelle, either.
“All we did was spend all day in bed,” said Rachel, who lives with her mother in SeaTac. “It was hard to get up and do floor time and just really interact with her.”
It was more than the typical mood swings that many new mothers experience. But Rachel didn’t exhibit the signs of postpartum psychosis — such as thinking about harming herself or her baby — either.
She said her doctor recognized that the typical questionnaires she was answering were made with adult mothers in mind, not teens, and weren’t registering Rachel’s less-severe but still very real postpartum depression.
Although medication was an option, Rachel decided she wanted counseling instead, which brought her to Kent Youth and Family Services.
Rachel was struggling to figure out how to love this new person in her life “because she was really hurting, feeling like she had disappointed people,” Ellsworth said.
Annabelle was in pain, too, but she didn’t know how to express it.
Babies’ emotions bounce around from moment to moment, so they tune in to their parents’ feelings to learn how to manage their own. Ellsworth understood that Rachel and Annabelle’s emotions were linked, so if Annabelle felt irritable, it made her mother irritable, which in turn made Annabelle more frustrated, and soon the day was lost.
From the start, Rachel could see how her own stress, and the arguments she had with Annabelle’s teen father, made her daughter anxious — an insight that often eludes older parents.
“It was really exciting to see this young lady really be able to make a pretty big connection,” Ellsworth said.
Ellsworth worked with Rachel and Annabelle twice a week for 18 months on ways to interrupt that cycle and strengthen their bond. She taught Rachel deep-breathing techniques to calm her when she felt anxious.
Annabelle became more aggressive and angry than was typical for her age as she became a toddler, Ellsworth said. But as Rachel learned to manage her own emotions, Annabelle began managing her own feelings better, too.
Meanwhile, Rachel got her education back on track, arranging for tutoring and day care so she could return to Highline for her senior year and graduate, which she did.
She reached another milestone when she accepted the fact that Annabelle needed therapy for a speech delay and it didn’t mean that she had failed as a parent.
Ellsworth knew her work was near an end when Annabelle began acting more like a kid at a play date and less like a kid in therapy.
She remembered one session in particular when Annabelle raced to the toys and soon she was playing at being a mom herself.
“She started feeding the babies and she was babbling, trying to narrate what she was doing,” Ellsworth said.
Rachel told Annabelle to stop doing something and she pouted for a second — and then moved right on.
“Six months earlier, any sort of a redirection would have caused a really big meltdown for her where she was stiff and arching backward and screaming and hitting and biting,” Ellsworth said. “It was a huge shift.”
John Higgins: 206-464-3145 or firstname.lastname@example.org On Twitter @jhigginsST