Keeping close: mothering with serious mental illness.
AIM: The aim of this paper is to describe the experiences of mothers with serious mental illness from their perspectives and how they attempted to manage their mothering circumstances. BACKGROUND: The desire to mother in women with serious mental illness is increasingly acknowledged by healthcare professionals. For these women, mothering is often framed as a pathological problem needing professional intervention. Yet little is known about mothering and illness from the perspectives of the mothers themselves. METHOD: Using Glaser's grounded theory approach and both purposive and theoretical sampling, interviews were conducted with 20 mothers who were receiving treatment for mental health problems. The data were collected in 2002. FINDINGS: We found the core category of Keeping close described mothers' efforts to have meaningful relationships with their children in the context of illness and suffering. To this end, mothers chose strategies that would hide illness for the sake of protecting their roles and their children. These strategies--masking, censoring speech, doing motherwork and seeking help--served to imitate ideal perceptions of mothering while making illness invisible to their children. Mothering in illness, however, became a vortex of contradictions, resulting in mothers 'hitting bottom', a point in time when they realized they could not keep close via pretences. To return to the valued place of mother, they sought treatment, hoping to learn how to be with their children authentically. CONCLUSION: To assist mothers with serious mental illness, healthcare professionals must be sensitive to the social and cultural context in which they mother in order to create healthier possibilities for nurturing their children.