Psychotic Reactions Associated With Pregnancy and Childbirth

Puerperal depression and excessive compliance with the mother

“…The patients were seen at University College Hospital and also at the Cassel Hospital where mothers with a psychiatric illness are admitted with their children (Main, 1958). This clinical experience supported Hemphill's finding that there is a clear-cut clinical entity of puerperal depression, distinct from manic-depressive psychosis (Hemphill, 1952), and the work of other writers (Brew & Seidenberg, 1950; Boyd, 1942) who suggest that the patients have a characteristic type of personality. This paper is largely concerned with this type of personality, and aspects of it which lead to the breakdown, particularly that which grows out of the early relationship between the patient and her mother.…”

Offspring of women with nonorganic psychosis: infant attachment to the mother at one year of age

“…A number of clinical investigations of mothers with psychosis have observed that the mothers' interaction with their infants is abnormal and characterized by rejection, inconsistency and hostility (21)(22)(23)(24)(25)(26). Mothers suffering from serious mental disorder are thus less likely to provide conditions which foster the development of secure attachment in their infants, and their offspring may be hypothesized to have an increased frequency of anxious attachment.…”

Post partum disturbance ... A review of the literature in terms of stress response

“…the “post partum blues” 6 . While there is general agreement that post partum disturbance does not constitute a discreet nosological entity 6,2,7 , there is confusion over psychological and physiological predispositions, and the nature of the interaction of the etiologic factors. Viewed in an holistic manner, post partum disturbance has many characteristics of a stress response inasmuch as environmental conditions of childbearing create a stimulus for an acceleration in the rate and an increase in the amount of anxiety.…”

“…Racial factors were not controlled for in the subjective evaluation though wide educational discrepancies were noted between white and black patients. Also, no attempt was made to differentiate patients suffering “maternity blues” or the mild depression described by Pitt 7 and Yalom.…”

“…The interactions of the physiology of pregnancy with psychological processes is acknowledged but the events are only vaguely correlated. Markham and others note the reactivation of earlier conflicts 14,7,13 and describe a constellation of psychodynamics of the woman with severe post partum disturbances. She cites 1) a distorted relationship to the maternal figure based on intense dependency needs of a symbiotic quality, 2) massive hostility to the maternal figure contrasting sharply to positive patient‐mother feelings in the normal parturient described by Robin, 3) severe inner conflict around phallic wishes and the hope of possessing a penis through bearing a male child.…”