Acute dissociative reaction to spontaneous delivery in a case of total denial of pregnancy: Diagnostic and forensic aspects

Şar, Vedat; Hart, Onno van der; Frankel, Anne; Şar, Meriç; Omay, Oğuz

doi:10.1080/15299732.2016.1267685

Cited by 14 publications

(6 citation statements)

References 14 publications

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“…A recent case report describing “unperceived (total denial of) pregnancy” (Şar et al, 2017c) ends with the words of the affected young woman who underlines the connection between loss of trust and the feeling of being abandoned by one's own body:…”

Section: Embodied Trauma and Bodily Dissociation: Clinical Implicationsmentioning

confidence: 99%

Parallel-Distinct Structures of Internal World and External Reality: Disavowing and Re-Claiming the Self-Identity in the Aftermath of Trauma-Generated Dissociation

Şar

2017

Front. Psychol.

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The nature of consciousness and the autonomy of the individual's mind have been a focus of interest throughout the past century and inspired many theories and models. Revival of studies on psychological trauma and dissociation, which remained outside mainstream psychiatry, psychology, and psychoanalysis for the most part of the past century, has provided a new opportunity to revisit this intellectual and scientific endeavor. This paper attempts to integrate a series of empirical and theoretical studies on psychological consequences of developmental traumatization, which may yield further insight into factors which threaten the integrity of human consciousness. The paper proposes that an individual's experience of distorted reality and betrayal precipitates a cyclical dynamic between the individual and the external world by disrupting the developmental function of mutuality which is essential for maintenance of the integrity of the internal world while this inner world is in turn regulated vis-à-vis external reality. Dissociation -the common factor in all types of post-traumatic syndromes- is facilitated by violation of boundaries by relational omission and intrusion as represented by distinct effects and consequences of childhood neglect and abuse. Recent research conducted on clinical and non-clinical populations shows both bimodal (undermodulation and overmodulation) and bipolar (intrusion and avoidance) neurobiological and phenomenological characteristics of post-traumatic response. These seem to reflect “parallel-distinct structures” that control separate networks covering sensori-motor and cognitive-emotional systems. This understanding provides a conceptual framework to assist explanation of diverse post-traumatic mental trajectories which culminate in a common final pathway comprised of partly overlapping clinical syndromes such as complex PTSD, dissociative depression, dissociative identity disorder (DID), or “borderline” phenomena. Of crucial theoretical and clinical importance is that these maladaptive post-traumatic psychological formations are regarded as processes in their own right rather than as a personality disorder innate to the individual. Such mental division may perform in that internal detachment can serve to preserve the genuine aspects of the subject until such time as they can be reclaimed via psychotherapy. The paper attempts to integrate these ideas with reference to the previously proposed theory of the “Functional Dissociation of Self” (Şar and Öztürk, 2007).

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Section: Embodied Trauma and Bodily Dissociation: Clinical Implicationsmentioning

confidence: 99%

Parallel-Distinct Structures of Internal World and External Reality: Disavowing and Re-Claiming the Self-Identity in the Aftermath of Trauma-Generated Dissociation

Şar

2017

Front. Psychol.

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“…8,11 or to less obvious reasons such as potential psychological distress for the mother or impaired interactions between mother and child. [12][13][14] Since the 1990s, a few epidemiological studies (Appendix S1) have tried to better document pregnancy denial. They have suggested that women experiencing pregnancy denial were mostly middle-aged, 10,15 more often unemployed [15][16][17] and single 10,15,16 compared with the general population, and without any psychiatric history.…”

Section: Introductionmentioning

confidence: 99%

“… 8 , 11 or to less obvious reasons such as potential psychological distress for the mother or impaired interactions between mother and child. 12 , 13 , 14 …”

Section: Introductionmentioning

confidence: 99%

Pregnancy denial: a complex symptom with life context as a trigger? A prospective case–control study*

Delong

Eutrope

Thierry

et al. 2021

BJOG

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Design, setting and population A French multicentric prospective case-control study with 71 mother-infant dyads having experienced a pregnancy denial versus a control group of 71 dyads.Methods Data were collected in the week after delivery using an observational leaflet and two psychiatric scales (MINI and QSSP).Main outcome measures Statistically significant differences between the two groups regarding social, demographic, medical and psychiatric data.

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“…More recently, a study found that perceiving frequent fetal movements was associated with higher scores of prenatal attachment [14]. Several publications [15–20] report observations of cases of pregnancy denial. Only one retrospective studies focused on the future of the child [21].…”

Section: Introductionmentioning

confidence: 99%

Pregnancy denial and early infant development: a case-control observational prospective study

Auer¹,

Barbe²,

Sutter³

et al. 2019

BMC Psychol

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Background The denial of pregnancy is the non-recognition of the state of the current pregnancy by a pregnant woman. It lasts for a few months or for the whole pregnancy, with generally few physical transformations. In this study, we will consider the denial of pregnancy as a late declaration of pregnancy (beyond 20 weeks of gestation) as well as a lack of objective perceptions of this pregnancy. The main objective of this study is to explore the relationship between pregnancy denial and the development of the infant (attachment pattern of the infant, early interactions of mother-infant dyads, and early development of the infant). Methods The design is a case-control prospective study, which will compare two groups of mother-infant dyads: a “case” group with maternal denials of pregnancy and a “control” group without denials of pregnancy. A total of 140 dyads (mother + infant) will be included in this study (70 cases and 70 controls) and followed for 18 months. The setting is a national recruitment setting with 10 centers distributed all over France. The follow-up of the “cases” and the “controls” will be identical and will occur over 5 visits. It will include measures of the infant attachment pattern, the quality of early mother-infant interaction and infant development. Discussion This study aims to examine the pathogenesis of pregnancy denial as well as its consequences on early infant development and early mother-infant interaction. Trial registration Clinical Trial Number: NCT02867579 on the date of 16 August 2016 (retrospectively registered).

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Acute dissociative reaction to spontaneous delivery in a case of total denial of pregnancy: Diagnostic and forensic aspects

Cited by 14 publications

References 14 publications

Parallel-Distinct Structures of Internal World and External Reality: Disavowing and Re-Claiming the Self-Identity in the Aftermath of Trauma-Generated Dissociation

Parallel-Distinct Structures of Internal World and External Reality: Disavowing and Re-Claiming the Self-Identity in the Aftermath of Trauma-Generated Dissociation

Pregnancy denial: a complex symptom with life context as a trigger? A prospective case–control study*

Pregnancy denial and early infant development: a case-control observational prospective study

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