Psychotherapeutic considerations in genetic counseling.

It is essential to consider the psychodynamic aspects of genetic counseling to attain the best outcome for the family. Narcissistic injury (reduced self-esteem), excessive defensiveness, and depressive reactions may impede an effective resolution of feelings and preclude the necessary adaptation to genetic diseases and the new realities that have developed. Most parents of genetically affected children are capable of dealing with these conflicts. However, some individuals need help during the adaptation process by assisting them to grieve for their disappointments and to help them develop new goals for themselves and for the baby that was born. This paper describes psychodynamic concepts that might be explored to facilitate conflict-resolution resulting from the occurrence of genetic disease.