“If I Had Legs I’d Kick You”: Maternal Mental Health, Stress, and Risk

REEL INSIGHTS

Directed by Mary Bronstein, the film “If I Had Legs I’d Kick You” poignantly puts maternal mental health, parenting stress, and child maltreatment in the spotlight. Rose Byrne won the Golden Globe and has been nominated for an Oscar for her portrayal of struggling mother, Linda.

Linda is a psychotherapist—attempting to help her patients with their problems—while attempting to manage her own. Linda’s (nameless, and for almost the whole film, faceless) daughter has a feeding disorder, requiring her to be in a day treatment program, and to have nighttime feeds through a gastric tube. Conan O’Brien plays Linda’s own psychotherapist (apparently a psychiatrist since he discusses going to medical school). Her absent husband Charles (Christian Slater) is captaining a ship. Throughout much of the film, he is a disembodied voice on the phone, telling Linda what he thinks she should do, rather than empathizing. Their apartment ceiling collapses, forcing a move into a shared bedroom at a dodgy beachside motel. Linda’s daughter’s feeding pump frequently beeps with flow errors overnight. An exhausted Linda tries to sleep but ends up escaping with substances.

Linda skips the required family therapy for her daughter’s treatment, despite multiple reminders. She cannot apply the tools of our trade to her own situation, rather turning to illicit substances. And she hears about her failures from the doctor and therapist (“You of all people should know.”)

Stress levels rise through the film—Linda’s daughter not making weight progress, pressure from her husband and from doctors, frustration of her own therapist, and even Linda’s postpartum patient Caroline running out partway through her session and abandoning her baby with Linda. Caroline’s husband is no help, and police are called to pick up the baby. Linda insists that Caroline is not suicidal or homicidal, but “obsessed” with protecting her baby. In her care of Caroline, early in the film, we see Linda suggesting relaxation, then medication whilst Caroline protests that she is breastfeeding (Linda misses an educational moment about antidepressant safety in lactation), and later encouraging an emergency department visit.

Linda leaves her young, medically ill, sleeping daughter alone in the sketchy motel room at length repeatedly; Linda instead is sitting outside, going to a friend’s room, or going all the way back to be in her apartment—and drinking and smoking. She lies to her husband, saying she has a babysitter when she does not. When Linda tells her therapist that she left her young daughter alone at the sleazy motel, he tells her that she needs sleep.

When Linda attends group therapy, she yells and leaves, feeling set-up to fail. She yells at a parking attendant. In a poignant moment, a harried Linda suggests to her therapist that she might not have been meant to be a mother, “this can’t be it.” After impulsively pulling out her daughter’s feeding tube, when caught by her husband and neighbor in her lies about having a babysitter, Linda impetuously and repeatedly throws herself into the ocean.

Both Linda’s and her patient Caroline’s stories bring up the risk to children from maternal mental illness and stress, on the big screen. While neither may demonstrate a clear diagnosis, maternal mental health overtones and stress—including from lack of sleep—are evident. Linda’s support network is not working for her, something that appears undervalued in general when we consider maternal mental health and risk. Yet Linda is an educated financially stable White woman who is a therapist, and who has her own psychiatrist. Perhaps she gets special treatment when her colleague/psychiatrist does not report her for child neglect.

In the film, Linda watches footage of real-world women who have killed children. We see court footage of Yoselyn Ortega, the nanny who stabbed her young charges. We watch part of a forensic psychiatric interview of Andrea Yates by Phillip Resnick, MD, who served as an expert for the defense. The Chamberlain case (“a dingo ate my baby”) is mentioned.

Andrea Yates had drowned her 5 children in the throes of postpartum psychosis, thinking she was saving them from a fate worse than death. She had an altruistic motive, was eventually found Not Guilty by Reason of Insanity, and was subsequently hospitalized in a forensic psychiatric facility for decades.¹ Importantly, the highly publicized Andrea Yates and Susan Smith cases were noted by more than one-third of psychiatrists to change their pattern of inquiry about filicidal thoughts.² Anecdotally, many mothers have shared that they worried about an outcome like Andrea Yates if they did not get needed mental health treatment.

Untreated maternal mental illness, personality disorders, substance use disorders, and poor attachment may each elevate risk toward the child.³ Not unlike Linda, mothers who kill are often full-time caregivers, who are socially isolated and have limited resources.⁴ But this also describes a large proportion of the population, who would never harm their child. Most psychiatrists underestimate how common infanticidal thoughts are, and do not routinely inquire.² For patients who are parents, psychiatrists should consider both risks and potential resources.³

The most common motive for child murder by parents is fatal child maltreatment, though among mothers found legally insane, altruistic motives are most common.³ Altruistic cases—murder out of love— may include mothers who plan suicide and take their child with them; mothers experiencing psychosis who believe they are saving their child from a terrible fate; and mothers who believe they are engaging in a euthanasia-like act toward their beloved medically ill child. Initially described by Resnick, additional motives for mothers to kill their children include unwanted child, partner revenge, and acute psychosis.^3,5

Just as Linda’s and Caroline’s mental health conditions are not clear in the film, Linda’s nameless daughter’s full medical condition is not clear. It is a failure to thrive in need of catch-up growth, but could be a feeding aversion or phobia or an eating disorder. Children with medical illness are more likely to be victims of abuse and neglect. Supervisory neglect and medical neglect are suggested, along with caregiver burnout with partner absence, and attachment issues. Linda views her nameless daughter as a burden. Linda leaves her daughter alone asleep in the motel, while she gets intoxicated. Linda sabotages her daughter’s medical plan; her daughter has a feeding tube, but Linda does not even schedule appointments for family therapy despite the doctor repeatedly telling her to. In the real-world, to protect children and stressed-out families, clinicians need to appropriately consider maltreatment.

Psychiatrists as well as other health clinicians are required to report to Child Protective Services when there is a reasonable suspicion of child maltreatment—abuse or neglect.⁵ In the film, authorities are not contacted about Linda repeatedly leaving her medically ill daughter alone asleep at a shady motel while she uses alcohol and drugs, nor about Linda repeatedly not following through on family therapy appointments for her medically complex daughter. Rather, she is told to get a good night’s sleep by the psychiatrist and told that her daughter’s level of care will be reconsidered by the medical team. Is this because special patients who are in the health care professions get different care, because they are “one of us”? This does not protect the child or the mother. In the film, had health professionals recognized Linda’s distress and poor coping—whatever the cause—and done their duty by reporting which would lead to an investigation and supportive services being offered, her daughter may have had a much better outcome than her mother pulling out her feeding tube and then attempting suicide. The police are only called about (non-health care professional) Caroline abandoning her baby.

In sum, “If I Had Legs I’d Kick You” brings up many important themes for psychiatrists, including maternal mental health, stressed mothers in crisis, caring for a medically ill child, and risks of child maltreatment and filicide. While Rose Byrne’s performance is a tour-de-force in this intense film, it is uncomfortable to watch.

Dr Susan Hatters Friedman is the Phillip J. Resnick Professor of Forensic Psychiatry; a professor of psychiatry, reproductive biology, and pediatrics; and an adjunct professor of law at Case Western Reserve University in Cleveland, Ohio. She served as editor of Family Murder: Pathologies of Love and Hate, which won the Manfred Guttmacher award. 

Dr Joshua Friedman is a pediatrician at Akron Children’s Hospital.

References

1. Resnick PJ. The Andrea Yates case: insanity on trial. Clev St L Rev. 2007;55(2):147-156.

2. Friedman SH, Sorrentino RM, Stankowski JE, et al. Psychiatrists knowledge about maternal filicidal thoughts. Compr Psychiatry. 2008;49(1):106-110.

3. Friedman SH, Friedman JB, Sorrentino RM. Child homicide, child maltreatment, and maternal mental illness: a review. Focus. 2026;24(1).

4. Friedman SH, Horwitz SM, Resnick PJ. Child murder by mothers: a critical analysis of the current state of knowledge and a research agenda. Am J Psychiatry. 2005;162(9):1578-1587.

5. Friedman SH, Friedman JB. Mothers and child murder: how psychiatrists can help in prevention. Psychiatric Times. 2024;41(12).