Psychotherapy during pregnancy: opportunities and challenges. 1993

M St-André
Brown University School of Medicine, Providence, Rhode Island.

In this article, I emphasized the developmental receptivity of pregnant women to psychotherapeutic interventions. I selected four psychotherapy themes, illustrated with examples of brief, conflict-focused interventions with pregnant women and their families. The first theme that I discussed was conflicts over increased dependency needs, and I gave clinical examples of helping to express and to tolerate such needs. The second theme examined was narcissistic disturbances and pregnancy. I discussed both the impact of a burdening maternal ego ideal and the attempts to reestablish a narcissistic balance through pregnancy. In the third theme, reconciliative themes in pregnancy, I discussed the identificatory struggle with the mother's mother that is reactivated by pregnancy, both in renegotiating separation from her and in facing issues of rivalry. In the last theme, working through losses while giving life, I described a case of mourning during pregnancy. In the discussion, I examined various aspects of involving expectant fathers and other family members in treatment. Finally, I discussed various transference phenomena, including the fetus as a transference object, some aspects of the transference to the therapist, and the integration of different transference phenomena.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007752 Obstetric Labor, Premature Onset of OBSTETRIC LABOR before term (TERM BIRTH) but usually after the FETUS has become viable. In humans, it occurs sometime during the 29th through 38th week of PREGNANCY. TOCOLYSIS inhibits premature labor and can prevent the BIRTH of premature infants (INFANT, PREMATURE). Preterm Labor,Labor, Premature,Premature Labor,Premature Obstetric Labor,Labor, Premature Obstetric,Labor, Preterm
D009289 Narcissism A psychoanalytic term meaning self-love. Narcissisms
D009769 Object Attachment Emotional attachment to someone or something in the environment. Bonding (Psychology),Bonds, Emotional,Emotional Bonds,Object Relations,Symbiotic Relations (Psychology),Bonding, Psychological,Object Relationship,Psychological Bonding,Attachment, Object,Attachments, Object,Bond, Emotional,Bondings (Psychology),Emotional Bond,Object Attachments,Object Relation,Object Relationships,Relation, Object,Relation, Symbiotic (Psychology),Relations, Object,Relations, Symbiotic (Psychology),Relationship, Object,Relationships, Object,Symbiotic Relation (Psychology)
D010553 Personality Development Growth of habitual patterns of behavior in childhood and adolescence. Development, Personality
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011248 Pregnancy Complications Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases. Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D011575 Psychoanalytic Therapy A form of psychiatric treatment, based on Freudian principles, which seeks to eliminate or diminish the undesirable effects of unconscious conflicts by making the patient aware of their existence, origin, and inappropriate expression in current emotions and behavior. Balint Psychoanalytic Therapy,Psychoanalytic Therapy, Balint,Psychoanalytical Therapy,Therapy, Balint Psychoanalytic,Therapy, Psychoanalytic,Psychoanalytic Therapies,Psychoanalytical Therapies,Therapies, Psychoanalytic,Therapies, Psychoanalytical,Therapy, Psychoanalytical
D003220 Conflict, Psychological The internal individual struggle resulting from incompatible or opposing needs, drives, or external and internal demands. In group interactions, competitive or opposing action of incompatibles: antagonistic state or action (as of divergent ideas, interests, or persons). (from Merriam-Webster's Collegiate Dictionary, 10th ed) Conflict, Psychology,Psychological Conflict,Psychological Conflicts
D003858 Dependency, Psychological The tendency of an individual or individuals to rely on others for advice, guidance, or support. Dependency Burden,Dependency, Psychology,Psychological Dependence,Psychological Dependency,Burden, Dependency,Dependence, Psychological

Related Publications

M St-André
December 2014, Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives,
M St-André
April 2024, Acta obstetricia et gynecologica Scandinavica,
M St-André
December 2023, Small (Weinheim an der Bergstrasse, Germany),
M St-André
February 1997, Presence (Cambridge, Mass.),
M St-André
September 1994, The American journal of psychiatry,
M St-André
June 2014, Shanghai archives of psychiatry,
M St-André
September 2020, Primary care,
Copied contents to your clipboard!