In an attempt to illustrate the relevance of psychoanalytic theory and research to behavior medicine, an empirical investigation was conducted of females treated at a high-risk pregnancy specialty clinic (N = 58). Drawing from psychoanalytic object relations theory, it was hypothesized and confirmed that use of projection as a defense mechanism during pregnancy, superimposed on simplistic object relations, predicted an erosion of patient-provider relationships during the pregnancy/postdelivery period. Findings are interpreted through the perspective of mentalization, pertaining to individuals' ability to understand the mental states of self and others, specifically under significant stress. Implications for psychoanalytically oriented assessment and treatment, and for the rift between psychoanalysis and research, are discussed.
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"Psychology & Health 451 clinician may also serve as an additional or alternative source of support, particularly in high-risk pregnancy (Shahar et al., 2010). Identification of women in need of additional assistance following their delivery may improve their prognosis and reduce their chances of developing post-natal psychopathology following this surgical intervention. "
[Show abstract][Hide abstract] ABSTRACT: Abstract Objective: To investigate the protective role of sense of coherence (SOC) and perceived social support in the effect of emergency/elective Caesarian-Section on postnatal psychological symptoms and impairment in mother-infant bonding. Design: Thirty seven women delivering via an Emergency C-Section, 21 via Elective C-Section, and 38 through a vaginal delivery were assessed six weeks post-partum (Time 1) as to their PTSD and depressive symptoms, impairment in bonding, and SOC and social support. Symptoms and bonding difficulties were assessed again six weeks later (Time 2). Main and interactive effects of mode of delivery and the protective factors were examined. Main Outcome Measures: Post-natal depressive and PTSD symptoms and mother-infant bonding. Results: An emergency C-Section mode of delivery predicted an increase in PTSD symptoms in Time 2, but only among women with low levels of Time 1 social support. Time 1 SOC predicted a decrease in post-natal PTSD and depression. Conclusions: Social support might buffer against the potentially traumatic effect of an emergency C-Section. SOC appears to constitute a powerful dimension of post-natal resilience.
Psychology and Health 10/2014; 30(4):1-34. DOI:10.1080/08870446.2014.977281 · 2.13 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This paper's main thesis is that Irwin Z. Hoffman's thesis that psychoanalysis must choose between its worldview and quantitative scientific research creates a misleading dichotomy. First, because scientific research is not in itself a worldview but a means to ascertain empirical claims, and to the extent that psychoanalysis has such claims, they need to be ascertained scientifically. Second, the dichotomy is misleading, because there is nothing in science per se that contradicts the psychoanalytic ethos of exploring the self's complexity and helping patients to become more autonomous and lead fuller and richer lives. Finally, the paper calls for a deepening of the dialogue between psychoanalysis and the evolving paradigm of the cognitive neurosciences that has, in many ways, inherited Freud's original program of an evolutionary science of human nature. Such dialogue will enrich both psychoanalysis and this paradigm, and taking into account the findings of biologically based investigation of the human psyche will not dilute the psychoanalytic ethos.
[Show abstract][Hide abstract] ABSTRACT: This study examines the relationship between the psychoanalytic concept of object relations and real life behavior of being in an intimate relationship among heterosexual women. In a multi-method approach we used two different measures; the self-report Bell Object Relations and Reality Testing Inventory (BORRTI; Bell, Billington & Becker, ) and the performance based Thematic Apperception Test (TAT) Social Cognition & Object Relations Scale- Global Rating Method SCORS-G (Westen, ) to measure the object relations of 60 women. The Alienation subscale of the BORRTI and understanding of social causality subscale of the SCORS-G explained 34.8% of variance of the intimate relationship variable. Thus, women involved in a romantic relationship reported lower rates of alienation on the BORRTI and produced TAT narratives that were more adaptive with regard to understanding of social causality as measured by the SCORS-G than those not currently in a relationship. Results are discussed with reference to the relationship between object relations and real life measures of healthy individuals and in light of the need for a multi-method approach of assessment.