Unplanned pregnancies and abortion counselling. Some thoughts on unconscious motivations

In a climate where the numbers of abortions and repeat abortions are increasing, it is necessary to improve our understanding of the dynamics that motivate the behavior of abortion seekers. While genuine contraceptive failures do exist, many unwanted pregnancies result from unresolved conflicts carried over from the woman's early relationship with her mother. The management of any pregnancy is often accompanied by feelings of ambivalence, and abortion itself is an expression of ambivalence reflecting a previously unconscious wish for a baby and a conscious wish to end the pregnancy. How these issues are handled also reflects the position the woman occupies in her life cycle. Examination of the early mother-child relationship may shed light on what unconscious needs are being expressed through the "acting out" mechanism of repeat abortion. If the mother-child relationship failed to establish an internal representation of a caretaking function, the child will lack the capacity for self-care and may seek abortion as a deliberate mechanism of self harm. Until such conflicts are resolved, abortions may be repeated. The abortion experience may also reflect a desire for a woman to individuate from her mother. Abortion counseling offers women an opportunity to understand and work through the damage resulting from their relationship with their own mothers. One case study, of a 25-year-old undergoing her fifth abortion, provides an example of acting out psychic pain resulting from a damaging maternal relationship. This woman lacked the capacity for self-care and could only tolerate counseling sessions until she overcame the acute vulnerability imposed by her most recent abortion. Another case study, of a 27-year-old seeking counseling after experiencing overwhelming feelings of guilt, shame, and inadequacy, provides an example of a woman seeking individuation and unconditional love. This woman used counseling successfully to develop a better understanding of herself and a certainty that she could be loved despite her flaws. Such dynamics do not always inform the abortion experience, but abortion is always a distressing experience, and counseling should always be available. Abortion counselors must come to terms with their own ambivalent feelings and unconscious conflicts in order to serve their clients.     

Unplanned pregnancy and risk of maternal depression: secondary data analysis from a prospective pregnancy cohort

Purpose: to evaluate the relationship between unplanned pregnancy (UP), a common problem in high and low income countries and maternal depression (MD). Methods: Secondary analysis of data from a prospective cohort study with pregnant women recruited from 10 primary care clinics of the public sector in São Paulo, Brazil. Participants were questioned about pregnancy intention at 20–30 weeks of gestation. The Self Report Questionnaire score >7 was used to evaluated the presence of depression during pregnancy and 11 months after childbirth. Four groups of MD were defined: never; antenatal only; postnatal only; persistent (both antenatal/postnatal). Multinomial logistic regression was used to assess the relationship between UP and MD, controlling for confounding. Results: Data were analysed for 701 at the postpartum period. Five hundred and sixty-two (67.8%) women did not plan the pregnancy. Women with UP had 2.5 more risk of being depressed during both assessments (during pregnancy and postpartum) when compared to women with a planned pregnancy (RR: 2.5; 95% CI: 1.47:4.30). In the adjusted models, women with UP were significantly more likely to have persistent depression (RR: 2.3; 95% CI: 1.2:4.3). Conclusion: UP is an independent risk factor for persistent depression, but not for postpartum depression     

Abortion and Mental Health

Abstract

Unwanted pregnancy and abortion are common life events, and therapists are likely to work with clients who experience them. Legal abortion currently entails little physical or mental health risk; most women currently cope effectively with these life events without need of clinical intervention. But current abortion politics include efforts to make abortion a more threatening, stressful, and stigmatized experience and to create a “postabortion syndrome.” Using a stress and coping framework, we examine how antiabortion activists spread myths and misinformation aimed at women's appraisal processes, and discuss approaches therapists can use to enhance women's strategies for coping with abortion. We also discuss specific issues and useful techniques for counseling about abortion concerns, including cultural sensitivity and strategies for promoting positive sexual health.     

More thoughts on the unconscious: reply to Brody and to Lewicki and Hill

Brody (1989) and Lewicki and Hill (1989) present commentaries on my central thesis (Reber, 1989) that there exist powerful induction routines that operate largely independently of awareness and yield rich and complex tacit knowledge that resists attempts to make it conscious, although these commentaries are of dramatically different kinds. Because there is a fairly clear basis of agreement between Lewicki and Hill and the points that I made, this reply deals almost entirely with the issues raised by Brody. The focus is on two classes of issues: (a) those of a methodological nature that surround the general problem of doing experiments on unconscious cognition and (b) those that derive from considerations of evolutionary biology that provide a basis for arguing that implicit operations are primary and form the foundation for conscious processes.     

Some thoughts on happy and unhappy love

The subjective nature of love and happiness makes it difficult to examine them objectively. Outlining the purpose of human life as the search for happiness and the avoidance of suffering, Freud began the systematic study of the psychology of love. His most enduring contribution was the discovery of the link between adult and infantile love. Oedipal love gives us the feeling of certainty about what true love is. Mutuality and positive reciprocity are the secret of happy love. Love is a strong motivational drive in life, a force for psychosocial development and a central interest for humanity. It has a remarkable power for the enhancement of integration. Love is a simultaneous attempt to find something new and re-find something old. The author examines which psychological factors lead to a happy result and what factors lead to failure.     

Tattoo and taboo: on the meaning of tattoos in the analytic process

Tattooing projects a visual image in transference to form a backdrop for the most salient unconscious inner conflicts arising during an ongoing analytic process. Like a snapshot, the tattoo is a dialectic record of the mother-father relationship, of desires for closeness and distance, commonality and difference, identification and individuation. As Walter Benjamin famously stated about the nature of visual images in his Arcades Project, the tattoo represents "dialectics at a standstill." What seems paramount to the patient who participates in the act of tattooing is the need for stasis and immutability, as if bringing unconscious conflicts to "standstill" were to deliver a sense of stability. Unconsciously, the need is triggered by a threat to the inner stability resulting from fear of violating a taboo escalating to the point that fears of abandonment and fusion become unbearable. On the one hand, the tattoo is a visual symbolization of a taboo transgression; on the other hand, it activates the same through an act of self-injury that resembles the magical ritual acts of indigenous peoples' use of tattoos. The taboo thus serves as an ersatz for the actual violation of the taboo in real life, so that the tattoo may be ascribed a magical significance or totemic function. And yet the tattoo's success as a vehicle for constructing a transitional object is always contingent on the tangible manipulation of the skin conjoined with the creation of a symbolizing visual image. The image then acts like a "patch" to repair holes blown into Winnicott's "potential space" and to reconstruct it.     

Beyond beliefs: Challenging obsessive thoughts and compulsive behaviours within a collaborative counselling relationship

Three clients with obsessive‐compulsive disorder were studied using a multiple case study approach. Clients' experiences of cognitive‐behavioural therapy, in particular the impact of having their beliefs challenged, and their responses to self‐monitoring tasks and behavioural experiments were investigated. Data included case notes made during therapy, pre‐ and post‐therapy questionnaires, and post‐therapy semi‐structured interviews. Qualitative analysis of the data identified clients' obsessive beliefs, general negative beliefs and meta‐cognitive beliefs, and explored any post‐therapy changes in these beliefs. The results demonstrated similarities between cases in obsessive beliefs (e.g. inflated responsibility for harm), general negative beliefs (e.g. feelings of failure), meta‐cognitive beliefs (e.g. the need to control thoughts) and affect (e.g. guilt). Questionnaire data from all three clients suggested no clinically significant post‐therapy changes in general negative beliefs and meta‐cognitive beliefs. However, idiosyncratic changes in obsessive beliefs were reported during therapy and at post‐therapy interview, and clients reported improved functioning and decreased levels of distress during therapy and at interview. Responses to challenge were uniformly positive, but reactions to self‐monitoring and behavioural experiments varied across cases. The implications of these findings for the treatment of obsessive‐compulsive disorder using cognitive behavioural techniques are discussed.     

The sanctity of life: The role of purity in attitudes towards abortion and euthanasia

Although abortion and euthanasia are highly contested issues at the heart of the culture war, the moral foundations underlying ideological differences on these issues are mostly unknown. Given that much of the extant debate is framed around the sanctity of life, we argued that the moral foundation of purity/sanctity—a core moral belief that emphasises adherence to the “natural order”—would mediate the negative relationship between conservatism and support for abortion and euthanasia. As hypothesised, results from a nation-wide random sample of adults in New Zealand (N = 3360) revealed that purity/sanctity mediated the relationship between conservatism and opposition to both policies. These results demonstrate that, rather than being motivated by a desire to reduce harm, conservative opposition to pro-choice and end-of-life decisions is (partly) based on the view that ending a life, even if it is one's own, violates God's natural design and, thus, stains one's spiritual purity.     

Preliminary thoughts on the neurobiology of innate unconscious structures and the psychodynamics of language acquisition

This paper builds upon Britton's recent writing on ‘models in the mind’, in which he gives an account of preverbal metaphoric structures based on object relations (Britton 2015). These correspond with Jung's theory of innate unconscious structures. These innate models are considered alongside current linguistic theory following Chomsky and post‐Chomskyan views about language acquisition. Neuroscience evidence linking language and abstract thinking with structures involved in tool use are presented. The implications of these findings, and our understanding of the relational context within which language, metaphor and abstract thought are acquired, will be discussed along with the failures of symbolization and verbal communication common amongst those with severe narcissistic disorders.     

In sickness and in health: An exploration of some of the unconscious processes involved in the decision by family caregivers to place a family member with dementia in residential care

This paper explores the feelings, conscious and unconscious, evoked by the difficult decision to place a family member with dementia into residential care. In an exploratory study I interviewed five people who had made this decision with a view to exploring some of the unconscious processes involved in their decision-making. The interviews were interpreted paying attention to my understanding of the transference and my countertransference feelings and as triangulated by a psychodynamic supervision group.

Intimate contact with ageing and death evokes fears about mortality and activates primitive anxieties. The progress of dementia may amplify primitive or psychotic states of functioning, particularly those involving evacuatory projection, and family carers may resort to splitting off unbearable feelings of anxiety which such projections can evoke and may contribute to their decision to look for residential care.

Once placed in residential care different dynamics evolve and further difficult questions arise: how often to visit; whether and when to dispose of the person's possessions and ultimately how to grieve. The focus of this paper is, as far as it is possible, on the partner without dementia as an individual and the impact of their relative's dementia on their lives.     

Some thoughts on correspondence between saying and doing

Recent research on verbal-nonverbal correspondence is evaluated, and conceptual, methodological, and applied issues regarding correspondence are addressed. Directions for research concerning the correspondence training procedure and extended applications are suggested.     

Belonging without believing: religion and attitudes towards gay marriage and abortion rights in Northern Ireland

ABSTRACT

Same-sex marriage has become a divisive issue in established western democracies. As in earlier research on abortion, there is now a growing body of studies which suggests that religious factors, such as identity, belief and practice, are the most frequent predictors of opposition towards gay marriage. Yet, what we know about the combined influence of these religious factors remains unexamined. Mindful of this omission, this study examines the relationship between regular church attendance and a belief in God on attitudes towards same-sex marriage and abortion rights. Using the recent survey data from Northern Ireland, the results suggest that not only are those who belong but do not believe distinctive in terms of their demographic makeup, but they are also significantly more likely to adopt a liberal stance in relation to both these issues – gay marriage and abortion rights – than the most religiously devout, or those who both belong and believe.     

The whirligig of time: Some thoughts on Staddon and Higa.

Staddon and Higa's theory of timing finds analogy with physics' concern with the relativity of time and irreversible processes. Their model raises general issues about the nature and function of models and, specifically, the extent to which it has captured the stimulus events in temporal control.     

The Connolly Occupational Interests Questionnaire: Some psychometric data and comments on its use in counselling

Normative data from the Connolly Occupational Interests Questionnaire (COIQ) is reported for polytechnic students and for fifth and lower-sixth forms at a selective high school. The mean profiles show that the COIQ differentiates effectively between course groups. Further data is presented which supports the inherent viability of the inventory in terms of item characteristics and counselling applications.     

Correspondence between saying and doing: Some thoughts on defining correspondence and future directions for application

Israel (1978) evaluated and discussed research on positive and negative verbal-nonverbal correspondence. In the present report we attempt to delineate the relationship of correspondence training to two major intervention goals-producing (increasing) behavior and inhibiting (decreasing) behavior. The concepts of noncorrespondence and generalized positive correspondence are introduced. Past research relating to the correspondence analyses offered for the two intervention outcomes and possibilities for future research are discussed. The relationship of verbal correspondence training to the issues of response maintenance and response generalization is also examined.     

权变视角下的情绪劳动:调节变量及其作用机制

调节变量是近年来情绪劳动研究关注的重点问题之一。实证研究显示,反映员工个体特征、工作情境特征的多组变量以及文化情境对情绪劳动效应具有显著的调节作用。权变视角下的情绪劳动研究发现:(1)展现规则在组织、行业、文化三个不同水平影响个体在工作场所的情绪表达;(2)表层扮演潜在的消极效应可以借助个体内在的保护机制或通过组织管理干预被削弱、消除,甚至是转化为积极的力量;(3)深层扮演的积极效应具有较高的跨人群、跨情境稳定性;(4)文化情境对情绪劳动作用过程具有重要的约束作用。在一定条件下,情绪劳动要求、情绪劳动行为都可以成为有益于员工的组织生活要素。     

First-person thoughts and embodied self-awareness: Some reflections on the relation between recent analytical philosophy and phenomenology

The article examines some of the main theses about self-awareness developed in recent analytic philosophy of mind (especially the work of Bermúdez), and points to a number of striking overlaps between these accounts and the ones to be found in phenomenology. Given the real risk of unintended repetitions, it is argued that it would be counterproductive for philosophy of mind to ignore already existing resources, and that both analytical philosophy and phenomenology would profit from a more open exchange.