Clinical Psy.D. Program, California School of Professional Psychology, Alliant International University.
Center for Reproductive Psychology, San Diego.
Psychotherapy (Chic). 2017 Dec;54(4):373-379. doi: 10.1037/pst0000127. Epub 2017 Oct 2.
Parenting after pregnancy loss is often complicated for people who have not effectively grieved the loss and worked through the trauma. Reproductive losses can trigger shame and self-doubt, damage the sense of self-as-parent, and inflict narcissistic injuries, which, in turn, may impede the resolution of grief. If not addressed, these unresolved feelings may be projected onto subsequent children, potentially disrupting attachment relationships and the child's sense of self. The reproductive story, a lifelong internal narrative that comprises the thoughts, feelings, and hopes about how parenting and adulthood will unfold, and forms the core of parental identity, can be used as a tool in helping parents understand the depth of their feelings, integrate current and past losses into the self, and resolve grief. The authors discuss 3 crucial aspects of intervention with parents who have had pregnancy losses, aimed both at healing the parents themselves and at protecting attachment relationships with subsequent children: (a) initially staying present-focused and engaging with the painful details of the loss experience, to normalize and validate the patient's grief and trauma, counteract shame, and begin repairing narcissistic injuries; (b) eliciting the reproductive story to identify and integrate past losses, and in its revision, to allow for hope and repair; and (c) attending to both acknowledged and denied grief. The challenges and satisfactions of working with this population and potential countertransference reactions are also discussed. (PsycINFO Database Record
为人父母是一件复杂的事情，尤其是对于那些未能有效处理悲伤情绪和创伤经历的人来说。妊娠失败可能会引发羞耻感和自我怀疑，损害自我作为父母的感觉，并造成自恋伤害，而这些反过来又可能阻碍悲伤情绪的化解。如果这些未解决的情绪没有得到处理，它们可能会被投射到后续的孩子身上，从而破坏依恋关系和孩子的自我意识。生殖故事是一种终生的内在叙述，包含了关于为人父母和成年生活如何展开的想法、感受和希望，构成了父母身份的核心，可以作为帮助父母了解自己感受深度、将当前和过去的损失融入自我并化解悲伤的工具。作者讨论了对有妊娠失败经历的父母进行干预的 3 个关键方面，旨在治愈父母自己，并保护与后续孩子的依恋关系：（a）最初关注当下，参与到失去经历的痛苦细节中，使患者的悲伤和创伤正常化和合法化，对抗羞耻感，并开始修复自恋伤害；（b）引出生殖故事，以识别和整合过去的损失，并在其修订中，允许希望和修复；（c）关注已承认和未承认的悲伤。还讨论了与该人群合作的挑战和满足感，以及潜在的反移情反应。
