Emergence and resolution of ambivalence in expectant mothers

Article Abstract:

Expectant mothers with a history of psychological disturbance pose a special problem for the psychotherapist. In addition to existing mental disorders in these women, natural physical and psychological changes of pregnancy may result in feelings of ambivalence. Research tends to concentrate either on the physiological correlates of pregnancy or else attempts to determine if a woman's dreams and fantasies are predictive of maternal behavior. A case of a 22-year-old woman with a history of mental illness who was pregnant for the first time illustrates that pregnancy can lead to highly aberrational fantasies that reveal potentially destructive impulses. The details of the woman's case, including her dreams, are presented and indicate that the woman harbored unconsciously destructive impulses toward her child and was ambivalent about her own abilities as a mother. According to the author, therapists confronted with expectant patients should utilize special therapeutic techniques to explore the extent of the woman's ambivalence, and develop methods of reassuring the patient of her abilities as a mother. A concept referred to as 'previewing' is discussed as a method of familiarizing a woman with her role once she is a mother. Some women who are disturbed may not be good at previewing, i.e. they may not be able to successfully imagine what having a baby is going to be like or envision themselves caring for the child. It is important that the therapist give the woman methods of verbalizing her ambivalent, perhaps even hostile impulses. It is hoped that the therapeutic use of the previewing technique will ultimately contribute to a reduction in the incidence of child abuse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Pregnant women, Ambivalence

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Self-mutilation in a new mother: a strategy for separating from her infant

Article Abstract:

Ordinarily, the emotional commitment of a new mother protects her infant from danger, and this relationship is generally perceived by the mother as a gratifying experience. Mothers who are able to adapt to their child's changing needs can anticipate change, and thereby support his natural development. However, some maladaptive mothers respond to their child's inclinations toward autonomy with hostility and impatience. The imminent separation of the infant from the mother's domain may cause the maladaptive mother great psychological upset which may result in self-destructive behavior. A case is presented of a 25-year-old mother who had experienced two psychotic episodes where she heard voices instructing her to hurt herself. The woman was unable to anticipate, or 'preview', her child's developmental stages, and her relationship with the child was passive and uncomfortable. During therapy, the patient's relationship with the child appeared to be improving. However, while in therapy, the woman became pregnant and underwent an abortion. Some time later, she was found to have burned her face with chemicals. It is suggested that in spite of the external change in the woman's relationship to her infant, her lack of adaptive skills was evident, and resulted in self-mutilation. It is posited that by engaging in this behavior, the mother was able to maintain a sense of control over her own anxiety about her infant's natural need to develop and separate. Diagnosis of such maladaptive behavior in young mothers requires a thorough history to identify other episodes of self-mutilation or self-destructive behavior. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Mother and child, Mother-child relations, Self-destructive behavior, Self injurious behavior

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Working through conflict with self-destructive preschool children

Article Abstract:

The case history of a three-year, ten-month old boy who diplayed maladaptive, disruptive and aggressive behavior is presented. The child and his younger brother were in the care of his maternal grandmother who was also undergoing therapeutic sessions with the child's therapist. The child's mother was a drug user and was continually in jail for various offenses. The therapist focused on establishing a trusting relationship with the child and allowed transference reactions. This strategy was successful since the child was able to work through his conflict. He developed and accepted a mature understanding of his caregivers and background.

Cases, Children, Cognitive therapy, Child psychotherapy, Cognitive therapy for children

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