Maria Muzik, MD, MSc –Motherhood in the Face of Trauma

Member Highlight –June 2017

  • Maria Muzik, MD, MSc (muzik@med.umich.edu)
    • Associate Professor, Department of Psychiatry, University of Michigan
    • Associate Research Professor, Center for Human Growth & Development, University of Michigan

What is the focus of your current injury research? 

My work focuses on women who have experienced interpersonal violence and trauma during the period from pregnancy into infancy and early childhood.  While the transition to motherhood is often full of hope and positive anticipation, it is also often a period of sleep deprivation, emotional intensity, and vulnerability.  Particularly for mothers who have experienced interpersonal trauma, the feelings of vulnerability and the normative need for support at this time can be triggering, or challenging to navigate, and can complicate the entry into parenthood.  Indeed, we now know a great deal from the basic research about how risk can be transmitted across generations— from parent to child— via both biological and behavioral pathways.   However, it is critical to note that we also know that these risk factors are not determinative— in other words— the data also show us how strengthening protective factors can improve outcomes for both mother and child, particularly in the face of early trauma and risk.   When we strengthen key protective factors, such as parental resilience, social support, knowledge of parenting and child development, and facilitate access to concrete resources in times of need, we promote greater resilience in parents and optimize later developmental outcomes for children.   

In our lab we have focused our work first on understanding how risk can be transmitted across generations— with an emphasis on identifying mechanisms and pathways that might be amenable to change, and therefore strong potential targets for intervention.  With those mechanisms identified, we have focused on developing and implementing preventive interventions and services to promote positive outcomes for parent and child.  It is often said, “If you really want to understand something, try to change it.”  As we implement these interventions we learn more about what changes, and why this is helpful, and we also learn about how different populations may benefit from or need different kinds of services and supports.  This has led us to the current broad phase of our research, focused on identifying how to increase access and availability of these services for all women and families.    We recognize the importance of having high quality “destination services and programs" within our University of Michigan-based psychiatric clinics, but just as importantly, recognize the need for capacity building and delivery in the community.  We are focusing on dissemination and implementation of our programs in the key places that parents with young children go and trust, such as primary care (pediatric and OB/GYN) clinics, or early childcare settings.  

We continue our work on the basic science underlying parenting, early transmission of risk, and identification of key pathways and mechanisms.  Yet increasingly we focus on preventive intervention and the development and delivery of a suite of services — from low intensity brief interventions delivered in primary care to multifamily group programs to strengthen parenting, social support, and coping skills, to access to high-quality psychiatric care and consultation— with an emphasis on making sure that these services are available and accessible to all women and children.  

Why is this interesting to you?

This period in time is so important because it is so often misunderstood, and experiences of intimate partner violence (IPV) and trauma affect so many mothers and young children.  Women often experience stigma and shame and feelings of isolation when they struggle with these experiences during this important time, and yet this time period offers such a tremendous opportunity for healing and growth.   It is wonderful to see how women who receive trauma-informed, strengths-based care at this time can grow stronger, more confident, and enjoy this period in ways that did not feel possible before those supports were available.  We have a huge responsibility to educate providers and to increase access to informed care— this is a matter not only of social justice— but of improving health outcomes for parents and children! 

What are the practical implications for this research in preventing injury, or in changes to injury-related policy?

Women who experience interpersonal violence and trauma are at greater risk for subsequent traumas, and the psychological consequences of IPV and trauma can lead to effects that interfere with mental health, positive parenting, and subsequent outcomes for the infant and young children.  Intervening early to promote parental resilience— including support for mental health, establishing social support, ensuring access to concrete resources, and positive parenting — can improve outcomes not only for the parent, but also strengthen outcomes for the next generation.  Thus intervention during this period is truly a “2-generation” approach, and the payoff likely carries forward in important and meaningful ways.  

What do you think is the biggest misconception of your line of work or the injury topic that you research?

Three misconceptions that are commonly heard: 

  1. MYTH: Pregnancy and early parenthood is a protected time when mothers are less likely to experience interpersonal violence.  
    • FACT: Women are very likely to experience IPV in this time period and prevalence rates are estimated up to 8%.
  2. MYTH: Infants are not affected by domestic violence.  
    • FACT: Infants are biologically hard-wired to seek safety and security from their primary caregivers, and observing their caregiver experience fear or anger is distressing and undermines the infant’s ability to establish safety and security in relationships.  
  3. MYTH: Once a person has experienced trauma or IPV it is ‘too late’ and they will be bad parents and/or their children will have poor outcomes.  
    • FACT:  Most women with histories of trauma and IPV engage in sensitive, responsive caregiving and all parents want to be the best possible parents they can be.  Having experienced trauma does not make you a bad parent, nor does it mean your child will have poor outcomes.  But trauma increases likelihood for mental health problems such as depression, anxiety and post-traumatic stress, and this can interfere with sensitive parenting. Yet for many mothers it can be very helpful to find resources for support in navigating this emotionally and physically complicated time, and accessing supports and building more coping skills at this time can go a long way towards strengthening positive experiences and early relationships.   

​​Click here to view Dr. Muzik's Michigan Experts profile.

Publication Date: 
Saturday, June 3, 2017
Article Type: