Honte et culpabilité. Naissance d'un enfant avec une malformation faciale

Abstract

À partir d’une analyse clinique du discours de parents d’enfants nés avec une fente labio-palatine et en nous aidant des théories psychodynamiques actuelles, nous nous sommes interrogés sur la place de la honte et de la culpabilité au sein du traumatisme que représente un tel diagnostic et sur le travail psychique que ces deux affects imposent et permettent. Nous mettons en avant l’importante expression de ces émotions, même si difficile, afin qu’un travail d’élaboration du traumatisme puisse se mettre en route.

Maternal Representations and Parenting Style in Children Born With and Without an Orofacial Cleft

“…A second possibility was to explain these results in the light of the intense work of support provided in Lausanne. As it is known from previous literature (see, eg, Field and Vega-Lahr, 1984; Barden et al, 1989; Bolomey et al, 2013) that the birth of a child with a facial difference can impact parental representations and attitudes toward the child, we could hypothesize than the availability of and the support provided by the cleft team helped mothers cope with emotions related to the diagnosis of the cleft, preventing those emotions from affecting their representations about their child. However, to clearly support this hypothesis, we should have compared results of this study to other work related to other care conditions.…”

“…The objective of the present study was to assess maternal representations of their infants at age 2 months (before the reconstructive surgery), 12 months (after surgery), and 5 years when school starts in children born with and without an orofacial cleft. According to previous studies (Field and Vega-Lahr, 1984; Dolger-Hafner et al, 1997; Skrivan-Flocard and Habersaat, 2009; Despars et al, 2011; Bolomey et al, 2013; Habersaat et al, 2013b), we expected that mothers of children with a CL±P would show more negative emotions, be less sensitive, and perceive their child as being more difficult before the surgeries, compared with mothers of children without a cleft. After surgeries, differences between groups in terms of maternal representations were no longer expected.…”

“…We suggested that, as a whole, these differences might reflect a deeper maternal involvement toward their child after surgeries. This result was in line with our clinical experience showing that, often, mothers have difficulty fully investing in children before reconstructive surgeries and considered these surgeries to be a “second birth.” Sometimes, when the shame about the child’s appearance was significant, these surgeries were considered to be the child’s social birth (eg, Bolomey et al, 2013). It was therefore possible, that after surgeries, mothers felt more emotionally involved or connected with the child and experienced emotions more intensely.…”

“…Despite the constant improvement in the medical and psychological care for families of children born with a cleft lip/palate (CL±P), learning that their children have a facial difference is still a challenging event for parents, involving different emotions such as fear, guilt, and shame (Skrivan-Flocard and Habersaat, 2009; Bolomey et al, 2013). Some studies have even highlighted symptoms of depression and posttraumatic stress in mothers of children born with a cleft, continuing months after birth (Field and Vega-Lahr, 1984; Dolger-Hafner et al, 1997; Despars et al, 2011).…”