The fantasmatic and imaginary child of the pregnant woman

背景:妊娠是一个过渡时期,在这一非常时期孕妇会变得更为脆弱,在不利条件下可能引发母婴心理问题。因此,我们有必要找出对这一时期会产生负面影响的因素。早期干预对保持孕产妇和婴儿的心理健康十分重要。目的:评估产前焦虑和抑郁的危险因素,特别是孕期和产后早期的孕产妇对胎儿和她自己的父母之间的母婴关系。方法:研究采用在孕期进行量化访谈,通过半定式孕期访谈来评估孕妇对胎儿的心理预期和孕妇自己的母婴依附关系归类。孕期访谈可得到有关孕妇与胎儿、孕妇和她生活中重要人物之间关系的有价值的信息。我们对斯德哥尔摩的孕20周的初产妇进行了调查,询问其有关怀孕的经历、以及他们的家庭、伴侣、和未出生的孩子之间的关系。研究的孕妇均属于有较高压力、童年逆境、有否精神疾病家族史的高危人群。这些女性更易罹患围产期焦虑和抑郁。结果:孕期访谈为了解孕产妇的心理构成提供了有价值的信息。她们心理状态和心理反应的量化可以用来衡量预测其母亲养育能力的质量。访谈中出现的反移情和移情有助于更深入地理解孕期女性的压抑、攻击性、悲伤、自恋、防卫等潜在动力学机制。结论:探究评估母孕期的心理构成以及她与未出生孩子之间的关系有助于进行专业的早期干预。早期干预措施应针对特定的高危人群,可有助预防对其孩子可能产生的不良效应。

Background： Pregnancy is a period of transition, which makes women more vulnerable and in unfavorable conditions may lead to psychopathology in both mother and infant. It is essential to outline factors adversely affecting the resolution of this period. Early interventions and why they matter： Interventions during pregnancy can provide important improvement in the outcome for both maternal and infant mental health. Aim： The aim of the study is to evaluate the risk factors of antenatal anxiety and depression focusing particularly on maternal representations of the relationship towards the fetus and her own parents during pregnancy and the early postpartum period. Methods： The study is outlined using a quantifiable interview during pregnancy to evaluate the woman＇s ability to keep her child in mind, measured by reflective functioning. Reflective functioning provides information regarding the pregnant woman＇s relationship quality to her fetus and important people in her life. Primiparae in Stockholm around gestation week 20 are asked about their experience with respect to pregnancy, their relationship to their family, partner, and their unborn child. The women selected to the study are an at risk population, with high levels of stress, childhood adversity, and/or history of mental health. These women are more vulnerable to develop perinatal anxiety and depression. Results： The pregnancy interview provides valuable insight into the pregnant women＇s psychic constitution. The quantifiable measure of their mental state, reflective functioning, serves as measure of quality of the mother＇s parenting capacity. The countertransference and transference of the interviewer towards the women during the interview enables a more profound understanding of the underlying dynamics and constructs of repression, aggression, mourning, and narcissistic defenses. Conclusion： A better understanding of the underlying mechanisms of the pregnant women＇s intrapsychic reorganization of motherhood and her relation to the unborn child shall facilitate specific early interventions. These interventions shall be targeted to specific risk groups and enable the prevention of adverse child outcomes.