Separation Struggles and the Trauma of Birth

Abstract

In this infant observation paper, I discuss how the experience of birth by emergency Caesarean section was reflected in the subsequent relationship between a mother and her baby. I explore the way in which the anxieties evoked were expressed between them in later separations, notably at weaning, and give thought as to how the psychic state of the mother's internal world, in the later stages of pregnancy, appeared to predispose her to such an experience of birth.The earliest anxiety of all -the `primal anxiety' of birth -is brought about on the occasion of a separation from the mother. (Freud 1926) Jack's birth by emergency Caesarean section, sudden and life-threatening both for him and his mother, constellated an experience where the fear of dying and separation became inextricably linked. The traumatic character of this birth, together with the nature and state of his mother's internal world, could be seen as creating the psychic environment that Jack was born into. If one considers the separation of birth as the prototype for subsequent separations, one might wonder if and how Jack's own experience of birth would contribute to his later anxieties around separating. Looking back over weekly observations of the first months of his life, I want to try and trace whether the repercussions of this experience did indeed get reflected, at this early stage, in succeeding separations, notably weaning. I shall look particularly at how the anxieties evoked were expressed between mother and baby. Integral to this will be to think how Jack's experience was affected for better or worse, by the containing capacities of his mother.I shall begin by focusing on the pre-birth period and consider his mother's internal state as she neared the end of pregnancy, since her feelings and phantasies about the baby and the forthcoming separation would be important ingredients in their subsequent experience.Jack is the couple's first child. Mrs N, an open-faced 29-year-old has one younger brother, and Jack is the first child to be born into her family for 25 years. When she was 11, her father left the family, and she has had little contact with him since. Mr N, aged 42, and somewhat reserved, is the eldest of three brothers and works as an academic. His father died some years ago. This essay received a Commendation. At the time of writing this paper ANTHEA GOMEZ was in the second year of training with the North of England Association for Training in Psychoanalytic Psychotherapy. She is currently in her final year, and works mainly in private practice, also doing some work at the Woodlands Road Clinic, for the South Tees Community and Mental Health NHS Trust. She is also a composer, and writes music regularly for BBC Radio Drama.