Document Detail

The psychoanalytic conceptualization of perinatal loss: a multidimensional model.
MedLine Citation:
PMID:  1415814     Owner:  NLM     Status:  MEDLINE    
Much has been learned about perinatal loss over the past 20 years through clinical investigations and quantitative research. However, a review of studies over the past decade reveals that perinatal loss is increasingly being seen in the same way as a death of any other member of the family, rather than as a unique bereavement. A comprehensive understanding of perinatal loss anchored in a theoretical framework of pregnancy is lacking. This article offers a multidimensional model for examining this loss by applying four psychoanalytic interpretations of pregnancy. 1) From the perspective of pregnancy ushering in the new developmental phase of parenthood, perinatal loss becomes a developmental interference, disrupting a significant milestone as well as causing isolation from peers. 2) In light of the usual recapitulation of earlier conflicts during pregnancy as noted by drive theory, perinatal loss may lead to an intensification of intrapsychic conflicts. 3) Understanding pregnancy as the creation of a specific person in an object relations model highlights the importance of mourning after perinatal death, as well as the need to tend to associated unresolved grief from earlier losses. 4) Finally, a model of narcissism describes how pregnancy reorganizes self-esteem, thereby delineating the intense narcissistic injury and rage that often follow perinatal loss. These multiple frameworks help to explain the many repercussions of this loss as well as to account for individual differences. Research findings are selectively reviewed to support the validity of this model. Conversely, this model may productively guide future avenues for research.
I G Leon
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of psychiatry     Volume:  149     ISSN:  0002-953X     ISO Abbreviation:  Am J Psychiatry     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-11-18     Completed Date:  1992-11-18     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0370512     Medline TA:  Am J Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1464-72     Citation Subset:  AIM; IM    
Department of Psychiatry, University of Michigan Medical Center, Ann Arbor.
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MeSH Terms
Fetal Death*
Models, Psychological*
Object Attachment
Parenting / psychology
Pregnancy / psychology*
Psychoanalytic Interpretation*
Psychoanalytic Theory

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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