Setting the Wire by Sarah C. Townsend

Review by Tracy Sidesinger

Setting the Wire is subtitled as “A memoir about postpartum psychosis,” written by a psychotherapist inside her own disjointed experiences of falling apart. Townsend uses theory to interrogate her experience, but by and large this is a raw, fragmentary, and human account of a mother’s unfolding mind in the months around childbirth when she wants nothing more than to be present.

While postpartum depression and anxiety have a higher incidence in the United States – they are reported to affect 1 in 7 women – postpartum psychosis still affects roughly 20,000 women nationally per year. Townsend recounts her symptoms of psychosis including paranoid delusions, severe disorganization, and being out of joint with time, as well as her journey through multiple treatment sites and psychiatric hospitalization. Her published words seem simultaneously a liferaft to herself and to the thousands of other women who may be alarmed and uncertain of how to get through this kind of distress. However, she does not achieve this in a manualized or clinical fashion. Rather, the entire book is a single lyric essay, broken into small sections of thought, thus mimicking parts of the psychotic experience itself.

Whenever I imagine something that I cannot yet see a way to, I think of a bank on the other side of a river where there is no bridge. I long for that bridge. Townsend, highly influenced by the film Man on Wire, suggests something far smaller to get to the other side: a tightrope. Such a connector is more precarious, but more possible and rife with associations. For example, Townsend observes that for a time she was linked to her therapist through a tiny but crucial telephone line. In contrast, the umbilical cord that improperly connected mother and baby in what is referred to as a “compromised attachment” is explored as the site of multi-generational fragile conjunctions in her lineage. For all its honest uncertainties, Setting the Wire weaves a thread through early postpartum distress and leaves its reader with a feeling that yes, it can be endured.

In a literary departure from psychiatric or diagnostic language – or pathologizing – the emphasis that remains in Townsend’s writing is psychoanalytic. Specifically, she writes, “More than hormones, I now think in terms of holding environments.” This includes sections on “psychic skin” and the extent to which one is held together by attuned others. She elaborates this by discussing the “inversion of psychic skin” whereby at birth a mother is tasked with being the container of another even when she has just lost a part of herself. Or, outside of birth, having to contain another when one is still a child.

Relatedly, Townsend explores that peculiar motif among mother texts: the wound. The opening of birth serves as a portal to other openings, and other traumas. Even our well-intentioned mothers still fail us. For those who experienced their own birth as traumatic, especially at the cellular level and not held in conscious memory, giving birth can unwittingly become a retraumatizing experience. Considering her mother’s absence during the birth of her daughter, Townsend writes: “She couldn’t watch me fall apart and hold herself together.” Her labor became insufferably slow when she believed her mother to be dying.

Like Townsend, at the time of childbirth I feared my mother was dying when she fled the delivery room. This had profound and immediate impacts on my capacity to bring my first child into the world. Labor halted under the weight of this delusion. The matrilineal wire was cut. In the palpable absence of this link, the mind fell apart, and psychotic symptoms appeared.

I read Townsend with urgency, not only for myself but for the significant number of Western mothers who are isolated into nuclear families that neglect the matrilineal line or other anchors of connection. She has set the wire for us, but in its precariousness, we need to hold it. This is done wherever we increase access to maternal mental health care such as offering peer support groups beginning in the prenatal period or integrating childcare into treatment clinics. Underlying any action, however, must be the question: What will hold mothers together between the site of our own births, and where we allow others to be born? 

Setting the Wire by Sarah C. Townsend


The Lettered Streets Press

$14.99 Paperback

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