Between listening and expression

This paper sets out to conceptualize what goes on in the analyst's mind as he listens—and expresses something—to the patient. Bion's ideas of approaching the patient's O, without memory and desire, are discussed. An alternate, more permissive, attitude to desire is suggested. This is based on the idea that containment, instead of denoting a dyadic interaction between mother and child, is a process which links the child to a begetting couple, thus a triad. Containing the patient corresponds, in the unconscious, to thinking about a sexual couple in a mutually beneficent interaction. Since the patient's anxiety, in his unconscious, parallels a frightening primal scene, containment is viewed as a continuous translation of a primitive primal scene into a mature act of love. A specific kind of genital desire is thus necessary for containment. This finds expression in the analyst's resonance with the patient. Clinical material from an analysis with a 7-year old boy is provided.     

The relationship between parental physical availability and child sexual,physical and emotional abuse: a study among a sample of university students in South Africa

The relationship between perceived parental physical availability and child sexual, physical and emotional abuse was investigated. The sample comprised 722 undergraduate students of psychology at the University of the North, South Africa. Participants filled in a retrospective self-rated questionnaire in a classroom setting. The questionnaire asked about perceived parental physical availability during childhood, and childhood sexual, physical and emotional abuse. Logistic regression analysis showed that, among all the participants, the factors "the participant not living with the natural (biological) mother until he or she was at least 16 years old" and "have ever had a stepfather or adoptive father until he or she was at least 16 years old" predicted child sexual abuse; and "have ever had a stepfather or adoptive father until he or she was at least 16 years old" predicted child emotional abuse. None of the other aspects of parental availability considered predicted child physical abuse. Mental health and social workers, educators and law enforcement agencies dealing with prevention and protection against child abuse should take note of the above identified predictors while designing programs for the eradication of child sexual, physical and emotional abuse.     

Single Parenthood and Adolescent Sexual Outcomes

Research suggests that children of single parents are at heightened risk of precocious sexual behavior, STDs, and other risky sexual outcomes. However, few such studies have addressed the type of single-parent family (single mother or single father), or differences across other-sex parent–child dyads. While gender essentialist models assume differences among youth living only with mothers or with fathers, constructivist models propose more flexible modes of parenting that lead to more similar outcomes. Using data from the National Longitudinal Study of Adolescent to Adult Health (n?=?2570) on youth between the ages of 15 and 19, we compared sexually-related outcomes among adolescents, both boys and girls, who lived with a single mother or a single father. These outcomes include sexual intercourse and knowledge, use of contraception, attitudes toward intimacy and pregnancy, and diagnosis of sexually-transmitted diseases. The results from linear and logistic regression models indicated few differences between single-mother and single-father families, or between same-sex and opposite-sex parent–child matches, using p values of .05 or smaller. Our results called into question essentialist models that posit higher risks for adolescents living with a particular parent or with an opposite-sex parent.     

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.

     

Effects of personality traits and characteristics of child sexual abuse on maternal reactions and support

Objective

This study aimed to examine the relationship between maternal and contextual factors including maternal personality traits, the quality of mother–child relationship, the characteristics of sexual abuse and maternal outcomes: (1) maternal reactions including feelings of anger and responsibility, anger and perceptions of responsibility of the child, and (2) maternal support provided to the child following the disclosure of sexual abuse.

Mentalization in children and mothers in the context of trauma: An initial study of the validity of the Child Reflective Functioning Scale

This study examined the validity of the Child Reflective Functioning Scale (CRFS: Ensink, Target, & Oandason, 2013, Child reflective functioning scale scoring manual: for application to the Child Attachment Interview. London, UK: Anna Freud Centre – University College London), a measure designed to assess reflective functioning (RF) or mentalization during middle childhood. Participants were 94 mother–child dyads divided into two subgroups; 46 dyads where children had histories of intrafamilial (n = 22 dyads) or extrafamilial (n = 24 dyads) sexual abuse, and a community control group composed of 48 mother–child dyads. RF of children and their mothers was assessed using videotaped and transcribed data gathered using the Child Attachment Interview and the Parent Development Interview (PDI: Slade, Aber, Bresi, Berger, & Kaplan, 2004, The parent development interview‐Revised. New York, NY: The City University of New York). The findings indicate that the CRFS proved reliable, with excellent intraclass correlation coefficients for general RF, as well as RF regarding self and others. Significant differences in RF were found between sexually abused children and the control group, and also between children who had experienced intrafamilial and extrafamilial sexual abuse. This provides support for the discriminant validity of the CRFS. Furthermore, maternal RF was associated with child RF. Both abuse and maternal RF made significant contributions to predicting children's RF regarding themselves, but child sexual abuse was the only variable that made a significant contribution to explaining variance in children's RF regarding others.     

Keeping fathers in mind

This paper focuses on keeping fathers in mind – in the mind of the mother and the mind of the therapist – as a symbol and as an actual person so that he can become a healthy presence in the mind of the child. Through its myths and laws, mainstream Indian culture constantly reinforces the idea that the child belongs first to the man who places ownership over a womb. This paper will focus on the importance of the father as a parent and not only as a sexual partner or keeper of the mother. It will illustrate that the actual presence of the father qualitatively enhances the child’s capacities and that the father’s absence or disengagement deeply and painfully affect a young boy. Through an account of some clinical work with young boys at a community-based psychotherapy clinic, the paper aims to illustrate the need of the boy for a good enough father, the reluctance of fathers to be involved in the parenting of their children, and the role of the mother in drawing in the father to be actively paternal.     

Treatment of a four-year-old victim of incest

Abstract

A case study describing the use of behavior techniques in the treatment of a four—year—old sexual assault victim is presented. The target behaviors included eating, phobic behaviors, self—injurious behaviors, and comments made about the father (the perpetrator) and the paternal grandmother. The child's mother served as both data collector and therapist. The study demonstrates that child victims can experience a sexual assault trauma syndrome similar to that manifested by adult victims. Additionally, the findings illustrate that a simple behavioral intervention implemented by a parent can be effective in treating young sexual assault victims.     

Impacting Awareness of Child Abuse through a Performing Arts Project

A folk opera, AVE, explored issues of child abuse, sexual assault and violence through the character of Mary Magdelene. Using indigenous religious folklore images, Magdelene is befriended by Jesus's mother and healed of her childhood wound through a religious conversion. Six hundred secondary students attended three daytime performances and 486 returned a Likert‐scaled questionnaire. Results indicated most students perceived abuse as a personally relevant, real social problem, with felt relevance increasing with age. Significant trends supported initial expectations with an increase in community and personal awareness of child abuse/sexual assault and an increase in personal and community interest in helping others. Community risk factors contributing to denial of abuse were explored. More Hispanics responded positively to the sense of benefit. Findings suggest that performing arts can help increase awareness of child abuse as well as help stimulate personal and community interest in helping. This benefit increases with teacher discussion and age.     

Establishing emotional mutuality not formed in infancy with Japanese families

Young mothers in Japan today are faced with a conflict between the traditional image of motherhood and a sometimes lonely life without physical and emotional support from their husbands, family, and community. As a consequence of this, more and more children are becoming emotionally disturbed as a result of poor mother-child interactions that arise as early as infancy. With several cases of poor interaction, hospital treatment was undertaken to establish emotional mutuality between mother and child through therapeutically induced regression into infancy. Each mother-child pair was hospitalized in the baby unit of the pediatric ward, and the mother provided consistent emotional availability to her child. The child then regressed into infantile states that involved the following four phases: (1) The child began to interact with her mother more actively; (2) she became demanding, like a toddler in the rapproachment crisis; (3) the mother's sustained acceptance won the trust of her child, who began to show a strong attachment to her; (4) the child began to progress to a stage appropriate to her age and used the mother as a secure home base. Each child lost previous symptoms and acquired a stable character. This approach, which utilized the Japanese affinity for intimacy and regression, proved effective in the management of psychopathologies rooted in infancy.     

Childhood correlates of adult levels of incongruence between implicit and explicit motives

The present study used archival longitudinal data from 5 years old children and their mothers to explore mother and child characteristics associated with motive incongruence 26 years later. Motive incongruence was assessed in terms of discrepancies between implicit and explicit measures of the need for achievement, power and affiliation. Previous research has suggested that trait self-determination, which involves self-awareness and perceived volition in one’s actions, moderates the level of implicit/explicit motive incongruence. We hypothesized that early childhood experiences that interfere with the development of self-determination would be associated with later motive incongruence. Our results showed that childhood factors that reflected mother–child difficulties in the areas of autonomy and relatedness were significantly related to adult levels of motive incongruence. Specifically, adult motive incongruence was significantly associated with strong maternal inhibition of the child’s dependent and sexual impulses, maternal separation during the child’s second year, and mother reports of feeling dominated by the child. Limitations of the data are discussed.     

Concurrent treatment of mother and child in resolution of multigenerational separation and individuation difficulties

This case serves as a paradigm of concurrent treatment of a mother and child, where the central problem was one of separation-individuation. The nature of the child's presenting symptom of night terrors, the overinvolvement of the mother and the child, and the tendency of the child to withdraw from the outside world, all pointed to a child at risk for the more symptomatic development of school refusal and greater psychopathology. Since the treatment took place within a full service community mental health clinic, it was possible to provide psychiatric evaluation and consultation of both mother and child and the use of two therapists working collaboratively. With this method of treatment, the unfolding of both mother's and child's separation-individuation processes could be identified and utilized. Since she was an electively mute child who refused to come into the treatment room, another therapeutic tool became the use of the younger brother as a facilitator.     

Women of the fifties: Their past sexual experiences and current sexual attitudes in the context of mother/daughter relationships

As part of a study on sexual communication between mothers and daughters, 141 college-educated mothers of college-age daughters completed a questionnaire on their past sexual activities (including high school and college experiences, first love experience, first experience of intercourse, first and successive pregnancies, and birth of first child). Mothers also indicated the degree to which they had experienced 14 sex-related fears during college and at present. Several questions tapped present sexual attitudes concerning themselves and their daughters. Mothers were asked how they would feel if their daughters never married, never had children, or had a homosexual relation. The majority reported that their sexual attitudes had become more liberal since college and indicated that their daughters had influenced these attitudes. The majority also indicated they were satisfied with the current sexual communication with their daughters and with the mother/daughter relationship in general.This work was supported by a grant from the Ford Foundation. Please address correspondence to Marilyn Yalom, Center for Research on Women, Serra House, Stanford, California 94305.     

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.     

The multiple self: working with dissociation and trauma

This paper describes a patient who appears to have a chronic dissociative personality disorder. Renewed clinical interest in dissociative disorders had arisen in North America in the 1980s, in part due to the influence of the Women's Movement which had highlighted the incidence of child sexual abuse. The early psychological observations of Janet, Freud and Jung on hysterical patients who displayed dissociative phenomena were similar to those displayed by the patient. consideration is given to theoretical understanding of the condition, taking into account the views of the earlier theorists and object-relations theory. The possibility of trauma, in particular childhood sexual abuse, as a causative factor in dissociative disorders is discussed.     

“Last Night I Dreamed I Went to Manderly Again”: Vicissitudes of Maternal Identifications in Late Female Adolescence

To move forward into sexual maturity with a sense of bodily agency, the girl must internalize identifications with the mother as a sexual adult in her own right. These new identifications arouse intense internal conflict brought on by internalization with its unconscious association with destructive oral aggression and the archaic fear of retaliatory maternal rage. The unconscious dilemma is how to metabolize the sexual mother and also keep her alive as an internal resource. I present material from analytic sessions and literature to illustrate a characteristic defensive fantasy of late adolescence and the underlying conflicts that the fantasy conceals and attempts to ward off. This fantasy links aggression, internalization, and associated unconscious phantasies of oral sadism. Internalization may be derailed if the daughter's conflicts around aggression are felt to be intolerable. When all goes reasonably well, the late-adolescent girl tolerates the intense aggression associated with internalization and metabolizes representations of the sexual mother as a resonating internal presence that supports and enhances progressive development.     

What's Fair When a Child Testifies?1

Undergraduates (N = 385) watched a 2-hr, videotaped, mock trial of a child sexual abuse case. The child testified in open court, with a barrier between the child and the defendant, or via closed circuit television. Students enacted the role of a juror, sibling of the defendant, or sibling of the mother of the victim. The judge either did or did not warn jurors that the barrier or video should not be considered evidence of the defendant's guilt. Use of the barrier or video did not influence guilty votes, the credibility of witnesses, nor the perceived fairness of the trial for jurors. Siblings of the defendant perceived these procedures to be biased and their use as unfair. Increased publicity about the use of barriers and closed-circuit television when children testify is recommended to reduce objections to these procedures.     

Mother–child relationship quality from preschool to adolescence: Variation by maternal education

Using longitudinal data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1088), we examine changes in maternal perception of closeness and conflict in the mother–child relationship from the child's preschool to adolescent years, with attention to variation by maternal education. Analyses using individual growth models show that mother–child closeness increases, while mother–child conflict decreases, from preschool to first grade. From first grade to age 15, mother–child closeness decreases, while mother–child conflict increases, both gradually. The decrease in mother–child conflict from preschool to first grade and the increases in mother–child conflict from first to fifth grade, sixth grade, and age 15 are less steep for mothers with a college degree than for mothers without a college degree. These findings underscore the importance of examining changes in parent–child relationships using longitudinal data across children's developmental stages and their variations by parental social and economic status.     

Children's Adjustment in a Climate of Political Violence: Comparing Mother and Child Reports

There is a dearth of research on parent and child reports regarding a parent’s parenting and its contribution to a child’s adjustment. Therefore, the current study examined: (a) the differences between mother and child reports of aspects of maternal parenting (i.e., care and control), among both boys and girls; (b) which parenting report (i.e., mother’s or child’s) makes a stronger contribution to mother and child reports of the child’s adjustment in the context of political violence. One hundred and twenty-one mother-child dyads (children aged seven to 12 years old (M?=?10.02, SD?=?1.03)), who were exposed to prolonged political violence, participated in this study. Maternal care and control were assessed by mother and child reports on the Parental Bonding Instrument. Child’s adjustment was assessed both by mother’s report of child’s total difficulties and child’s self-report of posttraumatic stress symptoms (PTSS). Results revealed that both the mothers of girls and the girls themselves reported higher care, in comparison to mothers of boys and the boys themselves, while mothers of boys and the boys themselves reported higher control. Higher maternal control, as reported by the child, was associated with the child’s self-reported PTSS. Higher maternal control, as reported by the mother, was associated with the child’s total difficulties, as reported by the mother. However, maternal care, whether reported by mother or child, was not found to be associated with the child’s adjustment. School-aged children and their mothers were in agreement regarding maternal dimensions and their contribution to children’s adjustment.     

Sequelae of child sexual abuse: a child and parent assessment

We present a case example of a 9-year-old, biracial girl and her mother. We integrate data collected from rating scales (e.g., Child Behavior Checklist; Achenbach & Rescorla, 2001), a free response measure (Thematic Apperception Test; Murray, 1943), and a direct observation measure (Parent-Child Interaction Assessment-II; Holigrocki, Kaminski, & Frieswyk, 1999, 2002) and reveal how a child sexual abuse victim's internal representations and symptoms manifest in both an interpersonal context and in the realm of play. We discuss assessment findings regarding how they provide for an idiographic understanding of the child.