Maternal representations and emotional availability among drug‐abusing and nonusing mothers and their infants

Both negative and idealized maternal prenatal representations may constitute a risk for mother–infant interaction. This study analyzed the role of maternal prenatal representations and pre‐ to postnatal representational change in predicting mother–infant emotional availability (EA) among 51 drug‐abusing mothers and their infants who participated in either psychodynamic group therapy (PGT) or received psychosocial support (PSS) and among 50 nonusing comparison dyads. Maternal representations of her child, the child's father, her own mother, self‐as‐mother, and self‐as‐woman were measured during pregnancy and at 4 and 12 months' postpartum with the Interview of Maternal Representations (M. Ammaniti et al., 1992 ; M. Ammaniti, R. Tambelli, & P. Perucchini, 1998). EA was measured with the Emotional Availability Scales, fourth edition (Z. Biringen, 2008 ) at 4 and 12 months. The results showed that drug‐abusing mothers had more negative prenatal representations of the self‐as‐woman and of the child's father. Postnatally, PSS mothers tended to first idealize their child, but later to experience disillusionment of idealization. Both negative and idealized prenatal representations of the self‐as‐mother predicted mother–infant EA problems, but only among the PGT mothers. For all mothers, negative representational change was detrimental for the mother–infant EA whereas for drug‐abusing mothers, also increasing idealization from the prenatal period to the postnatal period was harmful. Clinicians working with drug‐abusing mothers should aim at supporting the development of a realistically positive view of motherhood.     

The Impact of Insecure Attachment on Mothering: A New Mother’s Story

This article describes the treatment of a first-time mother and her daughter. The mother’s impoverished primary relationships and the fragility of her early attachments contribute to her challenges with motherhood. Through parent-infant treatment she is gradually developing the capacity to reflect upon her experience and beginning to make discoveries about her attitudes toward herself and others. My work with Leslie has deepened my appreciation for Daniel Stern’s notion of “the motherhood constellation” and for the power of insecure attachment to destabilize the parent and consequently the parent-child relationship. During the treatment, I used the Newborn Behavioral Observations system as an adjunct to therapy to help demonstrate to this distressed new mother her infant’s competencies. Later, I also used the Adult Attachment Interview to enhance her curiosity about her own childhood, and in particular her relationship to her mother and the impact of that relationship on her own mothering.     

Frühe Störungen aus der Sicht zunehmender Mentalisierung

The term “mentalization” describes the capacity to judge other humans in terms of their mental activities such as wishes, hopes, beliefs and intentions, as well as the ability to think about one’s own thinking. Mentalization and reflective function are equivalent to each other. They play an important role in selforganization, impulse control, and affect regulation. Mentalization develops during approximately the first five years of life on the basis of attachment in Bowlby’s sense. Around the 9th month of life the child begins to understand her mother as an intentional agent. Mirroring by the mother, in a way of reproducing the child’s state of mind but in a slightly different “marked” manner, enables the child to establish a second “objectified” representation of her condition besides her primary unreflected one. Consequences of lacking, unmarked, or distorted mirroring for later narcissistic or borderline personality are discussed. The child begins now thinking, i.e. playing with representations, but the state of brain development allows to conceive of only one reality. Internal world and external reality appear undistinguishably identical. This is called the “equivalence mode” of psychic functioning. As-if-games open, in a further developmental step, the possibility of including a second reality, namely a pretended one. This is called the “pretend mode” of psychic functioning. At age four to five the child has reached the capacity to take multiple realities into consideration, to take the perspective of an other and to decentrate. She now has a “theory of mind”. Patients with early disturbances have reached this stage only partially. They may also regress to one of the earlier modes of psychic functioning as a consequence of stress or trauma. The knowledge of these early mechanisms helps to identify and understand them when they appear in our clinical practice.     

A Review of “Mind to Mind: Infant Research,Neuroscience, and Psychoanalysis”

Abstract

This article examines current research pertaining to the relationship between a mother and her children, and how this relationship may affect sibling interactions. Issues such as temperament, gender, and the age gap between children are also explored to ascertain their impact on the sibling relationship.

The displacement of the first-born child and the ensuing sense of loss and anger he may experience as a result of this is explored. The mother's second pregnancy is also discussed in regard to the impact of unresolved issues relating to her own sibling relations. The mother's interactions with each child, her role as a model for identification, and marital relations are discussed in light of their impact on sibling relations.

The evolution of a positive attachment between siblings is explored. Rivalrous behavior between siblings is also discussed, particularly in association to the mother's treatment of her own children and the manner in which the mother deals with her own aggression.     

Understanding the “ghosts in the nursery” of pregnant women experiencing domestic violence: Prenatal maternal representations and histories of childhood maltreatment

Selma Fraiberg and colleagues (1975) conceptualized the “ghosts in the nursery” as experiences from a mother's past that influenced her ability to form a warm and attuned relationship with her child. Contemporary infant mental health interventions often ask the mother to reflect on her own history of attachment relationships to gain insight into as well as to strengthen her developing relationship with her child. This study investigated the association between a mother's history of childhood maltreatment (CM) and her subsequent prenatal maternal representation during the third trimester of pregnancy. Controlling for domestic violence (DV), distorted prenatal representations were associated with higher rates of self‐reported childhood physical neglect. In addition, DV moderated the relationship between representations and CM, such that women who were exposed to DV during pregnancy and had distorted prenatal representations were least likely to report childhood physical and sexual abuse. Implications are discussed in relation to infant mental health interventions which rely on a parent's ability to psychologically access and reflect on childhood histories to more sensitively parent her own child.     

Coming Home/Coming Out

Abstract

This article is a theological reflection on one Queer Asian American woman’s experience of caring for her mother with Alzheimer’s disease. Using Coming Out/Coming Home as a frame and metaphor, the author explores the complexity of “home” for many Koreans/Korean-Americans whose very lives intersect with and are disrupted by major events in Korean and world history. For them, the act of coming home is complex, textured, and layered with experiences of loss, trauma, dislocation, resilience and hope. Through dis-ordered memories of a mother with Alzheimer’s, this article attempts to re-order what it means to come home. Grace Cho’s “ghostly haunting” provides a methodology. Layering theory with personal narratives, stories and a dream, ot is an experiment in performance—phantomogenic words that become “staged words.” In three parts, “coming home”, “ghostly hauntings”, and “tug-of-war”, this article performs coming home/coming out of one queer family’s experience of caring for a mother with Alzheimer’s.     

Mother–Daughter Relationship Quality and Body Image in Preadolescent Girls

Research suggests that mothers may play a role in girls’ body image development. The “interactive” hypothesis specifies that qualities of the mother–daughter relationship, as opposed to maternal modeling alone, predict daughter’s body image. We sought to understand how maternal relationship quality, from the perception of both daughters and mothers, was associated with preadolescent girls’ body image. The relationship between mother–daughter relationship quality and daughters’ body image was examined in 152 girls (ages 8–12) and their mothers. Mothers and daughters primarily identified as non-Hispanic white or Hispanic. Hierarchical linear regression analyses indicated that daughters’ perception of mother–daughter relationship quality was associated with daughters’ body esteem and body dissatisfaction, adding a small, but significant, amount of variance above the larger effect of child z-BMI and age. In contrast, maternal perception of mother–daughter relationship quality was not associated with any child body image measures. Young girls who perceived their relationships with their mothers more positively had healthier body images. Although effect sizes were relatively small and the cross-sectional design precludes conclusions regarding causality, these results support the “interactive” model of body image development whereby the characteristics of the mother–daughter relationship (as perceived by the daughter) are related to body image. Our findings support the notion that daughters’ perceptions of strong mother–daughter relationships are associated with healthy child body image, and fall in line with family-based prevention efforts that attempt to enhance parent–child relationships.     

Motherhood and Maternal Fitness of Mothers Whose Parental Rights Were Terminated in Israel: The Importance of Sexual Heteronormality and Legitimacy

Motherhood represents a social construct that is given meaning within patriarchal systems of law and custom. The present study analyzes the Israeli legal discourse surrounding motherhood, parenting capacity, and sexual conduct of marginalized women whose parental rights were terminated. It examines how information about a mother’s sexual heteronormal life style played a role in the construction of her motherhood as maternal unfitness. Drawing from 80 court decisions terminating parental rights, three themes emerged: the bad wife as a marker of the bad mother, “legitimate” sexual life as a pre-condition to desirable parenting, and negative views of women who give birth out of marriage. Maternal unfitness was associated with sexual immorality, illegitimacy, and “inappropriate” sexual choices. Alternative explanations of the findings are discussed from a critical feminist and legal perspective. Implications of the findings are outlined, particularly the need for women’s voices to be heard in every decision-making process regarding state control of their parenting, and the need for professionals to avoid bias against socially marginalized women and engage in critical reflective thinking regarding why information about a mother’s sexual conduct and life style is considered relevant to any assessment of her parental fitness and the child’s best interest.

     

Thought processes,Loneliness and Anxiety. Experimental and psychoanalytical investigations into creative thinking

The author questions whether Kernberg's suggestion that the interaction between splitting and other defence mechanisms—such as primitive idealization, omnipotence, devaluation and denial [disavowal]—gives an adequate psychodynamic explanation of borderline personality structures. The author shows that the assumption of a splitting mechanism provokes contradictions and that primitive idealization, omnipotence, devaluation and disavowal cannot be seen as genuine defence mechanisms. He argues that primitive idealization is a type of reaction formation and that the omnipotence of these patients can be put down to identification with the idealized ego-functions of their objects. He also maintains that the clinical phenomena can be understood as the outcome of a combination of an “equiparant” and “disequiparant” isolation, displacement, projection and primitive idealization, making the concept of splitting as an explanatory device superfluous.     

A home of her own: (Writing) a family story of separation and second chances

Abstract

On March 16, 1996, the author interviewed her mother, Beth Tillmann, about Beth's parents' divorce and her life as a foster child. From detailed notes taken during this phone conversation and from family stories told to the author throughout tier life, the author constructed a narrative titled “A Home of Her Own” Its structure and tone mimic the way her mother speaks about the dissolution of her family of origin and her attachments to and separations from those who tried to lielp her rebuild a sense of home. After the story is a discussion of what narrative representations of loss offer the writer, the subject, and the reader.     

On truth and reference in postmodern science

Abstract:

If the defenders of typical postmodem accounts of science (and their less extreme social-constructivist partners) are at one end of the scale in current philosophy of science, who shall we place at the other end? Old-style metaphysical realists? Neo-neo-positivists? … Are the choices concerning realist issues as simple as being centered around either, on the one hand, whether it is the way reality is “constructed” in accordance with some contingent language game that determines scientific “truth”; or, on the other hand, whether it is the way things are in an independent reality that makes our theories true or false? If, in terms of realism, “strong” implies “metaphysical” in the traditional sense, and “weak” implies “non-absolutist” or “non-unique”, what - if anything - could realism after Rorty’s shattering of the mirror of nature still entail? In accordance with my position as a model-theoretic realist, I shall show in this article the relevance of the assumption of an independent reality for postmodern (philosophy of) science - against Lyotard’s dismissal of the necessity of this assumption for science which he interprets as a non-privileged game among many others. I shall imply that science is neither the “child” of positivist philosophy who has outgrown her mother, freeing herself from metaphysics and epistemology, nor is science, at the other end of the scale, foundationless and up for grabs.     

Idealized and Industrialized Labor: Anatomy of a Feminist Controversy

Prompted by the ever‐increasing cesarean rate, this paper considers the interpretive disjunct between two significant strands of feminist analysis that have arisen in the last four decades as a consequence of the phenomenon of medicalized birth. In contrast to the dominant paradigm of bioethical “Principalism,” both modes of analysis, understood as “the critique of industrialized labor” and “the critique of idealized labor,” are attentive to the way in which social discourses inform bioethical deliberation and practice, but significantly diverge in the nature of their accounts. The “industrialization critique” understands the culture of medical intervention to be impelled by an “obstetric desire” to appropriate women's reproductive potency, whereas the “idealization critique” relates new mothers’ “low childbirth satisfaction” to a pernicious normative ideal propagated by the natural childbirth movement. This paper will explore the anatomy of both critiques and interrogate their fidelity to the phenomenological insight of the body as chiasm between material and ideal. I will argue that while the insights of the idealization critique are well grounded, we must exercise caution about the critique's tendency to reductively understand the embodied experience of labor as entirely discursively produced, a gesture that risks re‐performing the dematerialization of women often effected through obstetric intervention itself.     

Psychotic questing for heroism commentary on paper by Paul Williams

In this discussion of Peskin’s paper on who has the right to mourn (this issue), I explore what it means to “have a right.” When others reject our offerings, we may lose a sense of right to express ourselves and to be loved. Hierarchical rankings of grief, based on the image of limited good, help guarantee the restoration of this forfeited right to express our sorrows and be received by a caring witness. The vignette from Alice Kaplan’s memoir depicts not only how a young girl was prevented from mourning her father’s death by her mother, but also how a mother’s envy of her daughter may become its own source of loss and grief. The rivalry of Alice’s mother with her daughter for a “tragic childhood,” paralleling the rivalry underlying the rankings of grief, reflect a more widespread desperation for the precious right to openly express sorrow and receive the consoling reassurances of loving solace.     

And Three Made One: Psychoanalytic Work with a Three-Year-Old Girl in the Context of Reproductive Assisted Technology

ABSTRACT

The subjective experience of reproductive assisted technology (RAT) and the conceptual and clinical challenges it presents to contemporary child psychoanalytic practice is explored. Clinical material seeks to illustrate the impact of a mother’s relational past and her experience of infertility on the quality of her relationship with her young child and its impact on developmental progression. The role of the body as both organizer and container of experience is emphasized, as well as the role of the father and the parallel process between the mother-child dyad and the parental couple.     

Marco Conci interviews Marco Bacciagaluppi

Abstract

Following both Bion's and Aulagnier's thought, this paper seeks to examine two functions of psychotic syntax within the nonpsychotic personality. The first function is the creation of a split between voice and meaning in the mother–infant relationship, a split whose aim is to disengage contact with contents that cannot be metabolized and that are associated with the mother's denied death wish toward her infant. The second function pertains to the use of psychotic syntax as a way of denying separateness and annihilating the “speaking I.” Both functions will be exemplified by clinical case studies. In conclusion, psychotic language will be discussed as a “hybrid language” generated by an incestuous relationship between the mother's and the infant's language.     

Infant psychiatry clinic grand rounds. Unresolved grief: A two-year-old brings her mother for treatment

Rebecca was a 2 ¹/₂ -year-old Caucasian female who was brought to the Infant Psychiatry Clinic by her 28-year-old widowed mother. Her mother's chief concern was around parenting issues as well as how to explain to Rebecca the death of her father. This loss occurred when Rebecca was 6 months old and was a source of great pain and unresolved grief to her mother. Central to this case was the chaotic history of Rebecca's mother, who was a victim of incest from the time she was 13 until she was 23 years old. Both of her parents struggled with chronic alcoholism during much of her childhood. It appeared that a factor precipitating the mother's request for help was her struggle to move out of her own mother's home. This outpatient Infant Clinic case involved two primary goals: (1) the assessment of the parent-child relationship and (2) the development of confidence in this “good enough” mother. Vitally important to the process of treatment was the mother's modulation of timing and frequency of sessions. The issue of pacing was carefully monitored as this mother could have been overwhelmed by delving precipitously into her incestuous history. The use of a structured videotape interview to address mother-child interaction and parenting issues was particularly helpful. Referral to an AlAnon group provided the mother with social support as she separated herself from her alcoholic mother and moved toward autonomy in her own parenting role.     

Impossible obligations and the non-identity problem

In a common example of the non-identity problem (NIP), a person (call her Wilma) deliberately conceives a child (call her Pebbles) who she knows will have incurable blindness but a life well worth living. Although Wilma’s decision seems wrong, it is difficult to say why. This paper develops and defends a version of the “indirect strategy” for solving the NIP. This strategy rests on the idea that it is wrong to deliberately make it impossible to fulfill an obligation; consequently, it is wrong for Wilma to create Pebbles because doing so makes it impossible to fulfill her obligation to protect her child from harms like blindness. A challenge for the indirect strategy is the well-known “rights waiver problem”: Since Pebbles’s very existence depends on Wilma’s having made herself unable to fulfill an obligation to Pebbles, Pebbles is likely to waive that obligation. I address this problem by recasting the indirect strategy in terms of a non-grievance evil. I argue that deliberately making it impossible to fulfill a moral obligation manifests a defective attitude toward morality—an attitude which sees moral obligations as things to be dodged whenever they are inconvenient. Next, I argue that acting on this attitude is a wrong-making feature that is independent of any wrong that might be done to Pebbles. I conclude that Wilma’s decision remains wrong even if Pebbles waives any objection to it.

     

Crippled feet

Critics of Lars von Trier's film Antichrist have regarded the depicted woman's destructive fury as difficult to understand. In this paper, separation anxiety is discussed as a central unconscious motivation behind the aggressive interaction between husband and wife, and the child is discussed as an obstacle to the mother's exclusive relationship with her husband. The film powerfully conveys how sadistic aggression is unconsciously acted out between mother and son, as symbolized by the mother's crippling of her son's feet. The woman's violence is also a reaction to a her husband “therapist” who, wishing to correct her, fails to understand and contain her inner world, wherefore the therapeutic dialogue itself, disguised as help, is experienced as violently aggressive. This in turn engenders a wish for revenge. Against this background, the film is seen as a critique of cognitively oriented therapy.     

Breakdown in communication: On finding the child in the analysis of an adult

SUMMARY

In this paper a patient is described in whom communication with parts of herself and with her objects, internal and external, had broken down. I suggest that her way of communicating was achieved by projective identification, as described by Klein (1946) and Bion (1962). The only way she could deal with and communicate her own very “bothered” feelings was to “put them” into the analyst. In this way she “bothered” the maternal or analytic mind in such a way as to make the analyst experience feeling like a “bothered” child.

I have tried to show how the analyst holds or contains these feelings, and to show the gradual establishment in the patient of a different way of communicating with the analyst and with the more primitive parts of herself.