Abstract
This volume, edited by Paola Mariotti, focuses on central aspects of the mothering experience: how a woman arrives at wanting or not wanting to have children and how psychic factors rooted in early experience foster or hinder mothering desires, choices, and capabilities. It contains fourteen articles by prominent psychoanalysts, of which all but three have been published previously.
Compiling these articles into one volume allows the reader to see clearly the major patterns, ideas, and established knowledge that have emerged in psychoanalytic writing on this subject over the last sixty years. In an introduction and overview, Mariotti points to three organizing themes: first, the meaning and desire to be a mother start in the bodily and affective exchanges between a female infant and her mother; second, the psychic manifestations of maternality are organized through identifications with a maternal image, in a transgenerational lineage; third, maternality is also the expression of multilayered wishes structured in the oedipal period. These points are all the more convincing as they emerge repeatedly and with a variety of compelling clinical evidence, from psychoanalysis, to emergency interventions with women suffering from postpartum depression, to infant-child psychotherapy.
The book is divided into three major parts. The first is devoted to the general dynamics and development of the experience of mothering. The book begins appropriately with a little gem by Winnicott on “primary maternal preoccupation,” a special state lasting but a few weeks after delivery but necessary for the functioning of a “good enough environment” for the infant. (I would argue that this special hyperattention on the infant should and does last longer than the few weeks that Winnicott suggests.) There follows a very well written chapter by Dana Birksted-Breen, who argues that pregnancy facilities psychoanalysis, as it stirs up unconscious fantasies and offers the opportunity to reorganize defenses and internal object relations. Pregnancy also reveals shifting psychic boundaries between inside and outside and the woman’s relation to time. Of the many articles in this book, this especially focuses on the phenomenology and experience of a woman going through pregnancy.
Rozsika Parker continues this positive attitude in her chapter on shame and maternal ambivalence. With excellent illustrative clinical material, she suggests that there is a creative role for manageable maternal ambivalence. While maternal ambivalence is the focus of this chapter, the term runs through the book like a leitmotif, as every author underlines its positive and negative aspects in the experience and quality of mothering.
Rosemary Balsam’s chapter on the pregnant mother and the body image of the daughter brilliantly examines, in detail and depth, one of the more powerful images that become woven into the daughter’s identification with her mother and as a mother. The section is capped by another gem—Erna Furman’s clear, empathic look at the psychology of mothering. She emphasizes how motherhood forms the core of femininity for women and delineates the fluctuating nature of the maternal female body ego. Like many of the other contributors here, Furman describes the overwhelming and primitive threat of annihilation that is embedded in the early mother-child matrix.
Part two is devoted to issues of subfertility and reproductive technologies. The now disputed and discounted view that psychoanalysis can help infertility is revisited by Marianne Leuzinger-Bohleber in her discussion of the “Medea fantasy,” although the other authors in this section warn against psychogenic accounts of infertility. Leuzinger-Bohleber outlines unconscious fantasies in patients with sustained severe traumas that stem from early object relations characterized by envy, revenge, and an inner conviction of potential destructiveness. She suggests that these Medea fantasies arouse strong fears about having children. In contrast to these patients’ ferocious fantasies against motherhood, Joan Raphael-Leff presents a moving and informative account of her patient’s pained reactions to infertility and years of unsuccessful infertility treatments. Sharon Zalusky Blum offers another such case, which ended with the patient accepting a donor egg. Here Blum articulates the analyst’s countertransferences, reactions, and ethical struggles around the implications of this new technology, something all therapists will undoubtedly be experiencing more and more as time goes forward.
Although all the authors in one way or another articulate what can go wrong with mothering, the last section focuses on specific problems of miscarriage, abortion, postnatal depression, and abusive parenting. In all of these cases the ambivalence is intense and problematic. Dinora Pines speculates on some factors that might influence miscarriages. She illustrates with clinical material the underlying unconscious dynamics in women who by undergoing multiple abortions attempt to handle severe problems of separation and to punish themselves and their mothers for their guilt-ridden sexual and aggressive wishes.
Hendrika Halberstadt-Freud takes up a subject that has not been studied enough by psychoanalysis—postpartum depression. She speculates that a woman’s unresolved “symbiotic illusion” with her own mother can play a significant part in these conditions. For Halberstadt-Freud, “symbiosis” is a metaphor for the fantasy of common psychic boundaries between mother and daughter and encompasses conflicts around fusion and “primordial homosexual bonds.” She provides an especially compelling example of trauma across generations that resulted in a transmitted fantasy that the birth of a child would cause the death of the mother. Oedipal issues come into play also, as she explains women’s emotional struggles in assuming a maternal image by her concept of an Electra complex, characterized by a hatred of the mother and idealization of the father.
Alessandra Lemma’s compelling case material demonstrates difficulties in adolescent motherhood. She highlights the feelings of envy and deprivation in an adolescent mother who envies her baby for robbing her of her freedom or, the more dangerous constellation, projects an image of a withholding, depriving mother onto the infant.
Two chapters from different eras demonstrate gripping mother/infant psychotherapies. The ego psychological approach of Selma Fraiberg and Edna Adelson uses a combination of interpretation, support, and advice to save a baby who is failing to thrive and achieves surprisingly good and long-lasting results. Tessa Baradon, with her Kleinian approach, does a longer mother/infant psychotherapy with a severely disturbed mother who could not meet the baby “with passion and reverie.” Baradon describes her complex task in attempting to create meaning, to validate the parent’s experience, and to respond to the baby’s needs for an attentive adult mind. Here the results were less spectacular, but the richly complex clinical descriptions of the therapy are moving and fascinating.
The book ends dramatically, with Estela Welldon’s clear account of a transgenerational cycle of repetition of maternal abuse. She suggests the idea of chronic mourning in these women for a mother they did not have. Welldon, as is true of all the authors here, emphasizes the countertransference issues in the treatment, which in the case of abusive mothering are especially distressing.
In her introduction, Mariotti raises an interesting question of the relation of women’s sexuality and maternal functioning, which unfortunately receives relatively less attention in the ensuing chapters. Additionally, what struck me as I read the book was the general preoccupation with the idea of good mother versus bad mother: the authors’ questions about what makes for good-enough mothering; patients’ strivings to be good mothers and their struggles with good/bad mother images in their minds; therapists’ attempts to help patients become good mothers. Thus, the goal of describing the experience of mothering was transformed into this question, an interesting phenomenon in itself.