Defensive Projection, Superimposed On Simplistic Object Relations, Erodes Patient-Provider Relationships in High-Risk Pregnancy: an Empirical Investigation

Abstract

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.

Post-natal psychopathology and bonding with the infant among first-time mothers undergoing a caesarian section and vaginal delivery: Sense of coherence and social support as moderators

“…First and foremost, while social support can be defined from the traditional perspective of the spouse, the 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.…”

Object relations and real life relationships: A cross method assessment

“…When one deals with normal samples, OR levels are predicted to be in the normal range for both groups, thus making the difference in all subscales harder to detect. Hence, there is need for a systematic examination of effects of all SCORS subscales in a wide variety of samples (Shahar, Porcerelli, Kamoo et al, 2010) Regarding the BORRTI, although we predicted that all four subscales would be associated with the ability to be in a relationship, only the AL subscale remained following T-tests and the final logistic regression, though all other subscales exhibited an insignificant trend. As with the SCORS, past studies have shown that all subscales should have pointed to the difference.…”

“…When one deals with normal samples, OR levels are predicted to be in the normal range for both groups, thus making the difference in all subscales harder to detect. Hence, there is need for a systematic examination of effects of all SCORS subscales in a wide variety of samples (Shahar, Porcerelli, Kamoo et al ., )…”

Increasing Mentalization to Reduce Maladaptive Defense in Patients With Mental Disorders

“…Only isolated studies have considered these possible associations, and even fewer studies have empirically investigated the possible intercorrelations. Shahar and colleagues ( 39 ) emphasized a possible link between impairments in mentalizing capacities and the use of immature defense mechanisms, such as projection. The authors stated that individuals with lower mentalization scores were restricted in their use of defense mechanisms, as they had struggles identifying their own mental states and those of others.…”

“…The authors stated that individuals with lower mentalization scores were restricted in their use of defense mechanisms, as they had struggles identifying their own mental states and those of others. This may be an explanation for why highly burdened individuals have a tendency to use immature defense mechanisms, as people are less likely to tap the full potential of their own mentalizing abilities in situations of high emotional burden ( 39 ). In one case study ( 40 ), the author presented a phobic patient who continuously used the inhibition of mentalization as a defense against mental threats.…”