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Unplanned pregnancies and abortion counselling. Some thoughts on unconscious motivations
Authors:Loader B
Abstract: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.
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