This research examined clinical phenomena occurring in the phase of treatment following a therapist's return from maternity leave, with focus on the impact of primary maternal preoccupation (PMP; Winnicott, 1956) on the therapist and her clinical work. PMP refers to a psychological state of a new mother, occurring in the final weeks of pregnancy and into the postpartum period, that allows the mother to sensitively adapt to the infant's physical and psychological needs. Participants were 20 women who had returned to clinical work within six months of giving birth. Instruments were a PMP Questionnaire devised by Moulton (1991) and a semi-structured interview designed specifically for this study. Quantitative results revealed scores that fell within an approximately normal distribution pattern. PMP Questionnaire descriptive data did not differ significantly from those in Moulton's study, supporting the validity of the questionnaire. A k-means cluster analysis revealed that there were two distinct groups, one with high PMP scores and the other with low scores. Qualitative results from the interview revealed distinct characteristics of each group, though there were also some similarities. For therapists in the high group, PMP had both a positive and negative influence on their clinical work (positive: increased sensitivity to patients, a sense of feeling more vulnerable and “real” with patients; negative: increased distractibility, memory loss, fluid boundaries, and difficulty dealing with low functioning patients). In the low group, therapists were able to compartmentalize thoughts of their babies and felt that balancing dual roles actually served to sharpen their focus in their clinical work. On the other hand, these therapists expressed a sense of conflict between work and motherhood, appearing less flexible in their dual roles, and also had difficulty feeling vulnerable with patients, tending to constrict emotions. Overall, the results suggest that Winnicott's theory of PMP can be a valuable way of understanding a therapist's developmental movement, with the quality and quantity of PMP impacting transference and countertransference in the clinical setting. Limitations, clinical implications, and suggestions for future research are also presented.
|Commitee:||Diamond, Diana, Fenster, Sheri, Fraenkel, Peter, Jurist, Elliot, Tuber, Steven|
|School:||City University of New York|
|School Location:||United States -- New York|
|Source:||DAI-B 73/09(E), Dissertation Abstracts International|
|Keywords:||Clinical work, Countertransference, Primary maternal preoccupation, Therapist motherhood, Therapist pregnancy|
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