Nouvelles normalités Nouvelles pathologies Nouvelles ... - Psynem

6° 6éme Congresso Congrès Européen Europeo de di Psicopatologia Psychopathologie dell’Infanzia de l’Enfance e et dell’Adolescenza
de l’Adolescence
Nuove Nouvelles normalità normalités Nuove Nouvelles patologie pathologies Nuove pratiche Nouvelles pratiques
FRIDAY, May 6 WORKSHOPS
Workshop 14 Dal prenatale alla diagnosi precoce
PSYCHOLOGICAL INTERVENTION DURING PRENATAL DIAGNOSIS
D. Paggetti (1) , I. Lapi (2) , M. Iandolo (3)
(1) Meyer Paediatric Hospital, Florence (Florence - IT), (2) Manager of the Infant and Adolescent Mental Health Unit, Local
Health Authority, South-East Florence (Florence - IT); (3) Centro Studi Martha Harris, Florence (Florence - IT)
The progresses in foetal medicine allowed new
healthcare possibilities, making it possible for
pregnant women to find out a lot of information
about the soon-to-be-born baby.
However, this new way of experiencing pregnancy
has deep emotional consequences for
the woman, such as potential narcissistic
wounds which could undermine both the Self
and the emotional investment of the foetus, feelings
of mourning and death anguish. This could,
in some cases, cause what Rothman (1986)
called the tentative pregnancy, implying a kind
of psychological and emotional distance from
the foetus created by the mother. In fact, some
studies show that some women wait for the
results of the amniocentesis and the villocentesis
before emotionally investing in their pregnancy
(Besson, Golbius, 1979). The anxiety
experienced by the woman in relation to the
pregnancy and, later, in relation to the prenatal
diagnosis leads the woman to create a psychological
security distance from her baby. These
experiences can interfere with the development
of the mother-infant relationship. In a similar
way, the healthcare professionals’ emotional
experiences, the “countertransference” developed
in response to the patient’s projections
and their technical role are complex and difficult
to manage from a psychological and relational
point of view. The collaboration of the psychologists
of the perinatal psychology path within
the Prenatal Diagnosis Unit, part of the Perinatal
Psychology Path started by Florence Local
Health Authority, includes the following interventions:
support in the organization of the informative
sessions during prenatal diagnosis
addressed to the couples; assessment of the
women’s anxiety (both state and trait, through
the STAI) among those taking part in the prena-
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tal consultation, and, in cases of positive outcome,
proposal of support psychological sessions;
“binomial” physician-psychologist
consulting sessions during specific phases of
the prenatal consultation; inclusion of a psychological
session in the intervention program of
the unit, in cases of foetal pathology; team discussions
of the cases from a relational and emotional
perspective. In the full text of the communication
we report the quantitative and qualitative
data concerning the first semester of activity,
along with a few brief clinical examples. The
health consultation provided during prenatal
diagnosis, which represents an undoubted clinical
progress and a healthcare opportunity,
arises anxiety and leads, starting from the very
first weeks of pregnancy, to a strictly medical
path, which sets a distance from the pregnancy
experienced as a natural event, and leads to an
over-controlled pregnancy, surrounded by technicians
and experts. The emotional world, the
experiences connected to giving birth to a new
life, to expecting the baby, and to the new parental
role, are “put in the corner”, defensively hidden
behind the technical attitude of the professional
team and behind the - sometimes cold
and unresponsive, often full of doubts and anxiety-
woman’s and couple’s emotional suspension
(the tentative pregnancy, see also the work
of Beeson, Golbius, 1979, Rothman, 1986,
Righetti, 2010).The deep emotional consequences
of the prenatal diagnosis revolve
around potential narcissistic wounds, which
could undermine both the Self and the emotional
investment of the foetus (which, if damaged,
turns from an idealized narcissistic element
into a “perturbing” element, Freud, 1919),
feelings of mourning and death anguish, which
always accompany, both in a phantasmatic and