Celeste Duque 2004-2005 Pregnancy & Parenting Pregnancy transcends the moment of conception as the Maternity transcends the

mo ment of birth. 27/04/2008 More than events with different temporal durations, Pregnancy and Motherhood are processes. From the psychological point of view are dynamic processes of constr uction and development. 5 CLE - Psychology V 2 Pregnancy & Parenting [Cont.] The fact that a woman is pregnant does not automatically ensure that it can adap t to the fundamental necessity of realization of maternal tasks. 27/04/2008 5 CLE - Psychology V 3 Pregnancy & Parenting [Cont.] Pregnancy & Parenting are distinct realities, both organic and psychological ter ms. And, also, may not be coincidental. 27/04/2008 5 CLE - Psychology V 4 Pregnancy & Parenting [Cont.] The Maternity implies that most of you want to have a child, if you wish, above all, be a mother. 27/04/2008 5 CLE - Psychology V 5 Pregnancy & Parenting [Cont.] When it checks for a proposed adaptive maternity, pregnancy becomes a time that allows the woman's psychological preparation for motherhood. 27/04/2008

5 CLE - Psychology V 6 Pregnancy & Parenting [Cont.] Then allows: Test papers and maternal tasks, in terms of cognitive (beliefs, information); St art the restructuring process of emotional relationships to include the new memb er (in the family); 5 CLE - Psychology V 7 27/04/2008 Pregnancy & Parenting [Cont.] Incorporate the new presence (son) as their own identity, separate from itself; Learning to accept him and love him as a unique person with needs, desires and l ife itself. 27/04/2008 5 CLE - Psychology V 8 Pregnancy & Parenting [Cont.] And this, although, at first, and given the huge physical immaturity of this new being, requiring a relationship of great dependency on adults, for reasons of s urvival. 27/04/2008 5 CLE - Psychology V 9 Index 1. Motherhood as a stage of psychological development The concept of crisis in psychological development pregnancy as a crisis in the life cycle of women 27/04/2008 5 CLE - Psychology V 10 Pregnancy Importance of multidisciplinary teams: The psychologist should capture the emotional nuances and its manifestations at intra-and interpersonal, and help the obstetrician and nurses to deepen their un derstanding of the dynamic operation of the 5th CLE Psychology V-11 pregnant as a whole 27/04/2008 Pregnancy [Cont.]

The technological revolution of Obstetrics allows the realization of a pre and p erinatal increasingly sophisticated, reducing to a minimum the risks of maternal and fetus. 27/04/2008 5 CLE - Psychology V 12 Pregnancy [Cont.] The technological revolution of Obstetrics ends, however, a serious error: resulted in a profound dissociation between somatic and emotional aspects in cli nical care, whose conventional routine, both during pregnancy and childbirth and postpartum, rarely meets CLE 5 - Psychology V needs 27/04/2008 13 Pregnancy [Cont.] During pregnancy iniciamse: the formation of mother-child bond and the restructuring of the communication ne twork of the family: 27/04/2008 Starting point of a new dynamic equilibrium in the unit 5 CLE - Psychology V fam ily. 14 Pregnancy [Cont.] 27/04/2008 It is without doubt a moment that deserves the confluence of prevention efforts on the part of obstetricians, nurses and psychologists resulting in a more compr ehensive and satisfactory care for the physical and emotional health of the woma n and her child. 5 CLE - Psychology V 15 Maternity Motherhood is a fundamental existential moment in the life cycle of women. Can p rovide women the opportunity to reach new levels of integration and growth (deve lopment) of personality. 27/04/2008 5 CLE - Psychology V 16 27/04/2008 5 CLE - Psychology V 17 Psychological Perspectives

Contributions of Psychoanalysis This theoretical orientation is still today considered the most important becaus e it provides a very thorough clinical explanation of how it is personality deve lopment, although it is subject of bitter criticism, given the great importance 5th CLE Psychology given by V 4/27/2008 -Sigmund Freud to 18 Psychological Perspectives [cont.] Contributions from Developmental Psychology The trend of Developmental Psycholog y in which authors are included as Caplan (1967), Erikson (1959), Bibring (1961) is to conceive of psychological development as a continuum that extends beyond adolescence, marked in periods of crisis, which represent true turning points in emotional growth and determine, 5-in some way, the state CLE Psychology V 19 27/04/2008 Psychological Perspectives [cont.] Contributions of developmental psychology Which is to say that psychologically t he individual does not cease to grow, so there is always the possibility of rest ructuring, changes and reinstatements of personality. 27/04/2008 5 CLE - Psychology V 20 27/04/2008 5 CLE - Psychology V 21 Life cycle of women May be regarded as three great moments or critical phases in the life cycle of w omen, which constitute true stages of personality development and have some comm on points: Adolescent Pregnancy May 22 Climacteric 27/04/2008 CLE - Psychology V Life cycle of women [Cont.] These three periods have in common the fact that they are: periods of tension bi ologically determined, are characterized by complex metabolic changes, they are a temporary state of unstable equilibrium. 27/04/2008 5 CLE - Psychology V 23 Life cycle of women [Cont.] A temporary state of unstable equilibrium: 27/04/2008 arising from the prospect of major changes involved in aspects of: social role, the need for further adjustments, readjustments interpersonal and intra and 5 of identity. 24 CLE change - Psychology V 27/04/2008 5 CLE - Psychology V 25 Concept of Crisis Concept of crisis in psychological development: G. Caplan (1963), believes that

the crisis can be defined as a period of temporary disruption of the functioning of an open system, precipitated by circumstances beyond the transitional capaci dadesPsicologiasistema para26 V 5 CLE 04/27/2008 Concept of Crisis [Cont.] Concept of crisis in psychological development: Rapoport (1965), believes that t he crisis can be defined very simply as a temporary disturbance of a steady stat e. 27/04/2008 5 CLE - Psychology V 27 Concept of Crisis [Cont.] The word crisis was initially used by Caplan and Lindemann to designate uum indi vidual reactions to traumatic events such as sudden death of a loved one, birth of a premature fulham, unexpected unemployment, etc.. (Unforeseen crises). Psych ology V 28 5 CLE 27/04/2008 Concept of Crisis [Cont.] The same term was used by Eric Erikson to describe the various stages of normal psychological development, such as puberty, marriage, pregnancy, menopause (pred ictable crises). 27/04/2008 5 CLE - Psychology V 29 Concept of Crisis [Cont.] Thus, the term crisis can be used for both used when referring to periods of tra nsition as the unexpected inherent in the development. 27/04/2008 5 CLE - Psychology V 30 Concept of Crisis [Cont.] A crisis can be driven by internal changes: normal developmental crises, diseases or trauma;

or External: loss or threatened loss of a source of security and satisfaction, build up of te nsions that threaten to upset the balance of the functional adaptive mechanisms of the ego. 5 CLE - Psychology V 31 27/04/2008 Concept of Crisis [Cont.] Crisis always involves a temporary weakening of the basic structure of the ego, so that the individual can not use their usual methods of solving problems and, as such, require the mobilization of adaptive mechanisms of the ego in order to find new answers 5th CLE - Psychology V 32 27/04/2008 Concept of Crisis [Cont.] The strategy used by individuals to overcome their crisis 'existential' can be h ealthy or unhealthy: forcing the individual to experience an "improvement" (new level of integration and maturity of personality) or "worse" (higher degree of disintegration, disorg anization, and V 5 CLE - Psychology 27/04/2008 33 Concept of Crisis [Cont.] Moments or periods of crisis is precisely why, at the same time, moments of oppo rtunity and danger, are true crossroads in terms of mental health. 27/04/2008 5 CLE - Psychology V 34 Concept of Crisis [Cont.] The subject in crisis tends to more easily accept the help that is offered. Bein g a temporary period of unstable equilibrium, in search of new solutions, this m eans that the person becomes more sensitive and vulnerable 27/04/2008, 5 CLE - P sychology V but also more 35 Concept of Crisis [Cont.]

In general it is easier to help someone in crisis than someone who is in periods of stable equilibrium, when the defense mechanism and adaptation are more highl y structured, leading to a greater hesitancy to deal with change. Have a person in crisis, has no choice, there is no other alternative than to accept the May 3 6 and help change efectuarCLEasPsicologia V 04/27/2008 Concept of Crisis [Cont.] Caplan and his team (1964) concluded,€from their clinical experience in "crisis int ervention" that: You can help anyone overcome a crisis well, regardless of 5 CLE - Psychology V 27/04/2008 37 27/04/2008 5 CLE - Psychology V 38 Pregnancy as a Crisis Situation Pregnancy has many characteristics of a crisis situation, which is part of a nor mal process of development. 27/04/2008 Involves: Need for restructuring and readjustment to the level of several dimens ions: As it happens at puberty, there is a change of identity and a new definiti on of roles (the woman comes to see itself and be seen in a totally Psychology V form 5 CLE 39 Pregnancy as a Crisis Situation [Cont.] Case of primipara If parity Pregnant is the role of wife (or partner) to the role of mother. Here too there is a certain change of role: Being a mother of a child is not the same as being a mother of two or more children ... 27/04/2008 What is happening is that the arrival of another child requires the change of co mposition of family network intercommunication. 5 CLE - Psychology V 40 Parenthood as Crisis Situation [Cont.] Obviously the process of changing identity and role also exists at the level of the husband. Also parenthood should be considered as a critical level of emotion

al development of man. 27/04/2008 5 CLE - Psychology V 41 27/04/2008 5 CLE - Psychology V 42 Redefining Roles The woman may have played beyond the role of wife, until then, the role of "moth er" or "daughter" of her husband. When do you expect your own child has to adapt to this new role - being a mother of that child. 27/04/2008 5 CLE - Psychology V 43 Redefining Roles [Cont.] This new definition of roles is, often, to revive the old relationship conflicts . 27/04/2008 5 CLE - Psychology V 44 Redefining Roles [Cont.] The wife or husband may: Want to be better parents than their parents being unable to compete with them f ace the baby as a younger brother and as such compete for the affection of the f ather or mother, competing for the affection of the baby, etc ... 27/04/2008 5 CLE - Psychology V 45 27/04/2008 5 CLE - Psychology V 46 Socioeconomic factors The complexity of the changes caused by the arrival of a baby are not limited to psychological and biochemical variables. There are still considering changes in the level of socio-economic factors. 27/04/2008 5 CLE - Psychology V 47 Socioeconomic factors [Cont.] 27/04/2008 We live in a materialistic society in which the woman contributes her salary to the household income, usually working out, and cultivates diverse interest: prof essional study, career, social, cultural, CLE 48 5 - Psychology V Socioeconomic factors [Cont.]

The fact that an expected child entails consequences in the short, medium and lo ng term. Privations are real emotional or economic: They increase the tension, i ntensified regression and ambivalence. 27/04/2008 5 CLE - Psychology V 49 Socioeconomic factors [Cont.] Concern for the future: Increases the needs of pregnant and increase the frustra tion this causes, as a result, feelings of anger and resentment that prevent it from finding gratification in gravidez.5 of CLE - Psychology V 50 4/27/2008 27/04/2008 5 CLE - Psychology V 51 New Levels of Integration Another feature: It represents an opportunity to reach new levels: Integration, Maturity, and Expansion 27/04/2008 personality - both women and men. Or adopt a solution that predominate the patho logical level of the mother-baby. 5 CLE - Psychology V 52 27/04/2008 5 CLE - Psychology V 53 Mother-Baby Mother-baby healthy: It implies, in general, understand and meet adequately the needs of the baby, the baby is seen as being separate and not confused with the symbiotic mother. 27/04/2008 5 CLE - Psychology V 54 Mother-Baby [Cont.] Materno-filial pathological or diseased: The mother is unable to perceive and th erefore to meet adequately the needs of the baby, the baby symbiotically confuse d with the mother (mother and baby are one and the same person). 27/04/2008 5 CLE - Psychology V 55 Mother-Baby [Cont.] Mother-baby pathological or unhealthy is characterized also by the expectation t hat: the baby meets certain neurotic needs of the mother as, for example: avoid loneliness, to satisfy her need for affection; Make her feel useful. 27/04/2008 5 CLE - Psychology V 56 Mother-Baby [Cont.]

Or, the baby represents, symbolically, a diseased part of the mother, this is of ten the underlying dynamics of: endless trips to doctors with a request to find out "what's wrong with the baby, " when it is perfectly healthy. 5 CLE - Psychology V 27/04/2008 57 27/04/2008 5 CLE - Psychology V 58 Marriage & Pregnancy Pregnancy can: lead to greater levels of integration and deepening the relationship of the coup le; But on the other First, you can: break a fragile structure and neurotically balanced. 27/04/2008 5 CLE - Psychology V 59 Marriage & Pregnancy [Cont.] The woman who: Want to delete the husband of her life could not go beyond the stage of infantil e dependence in relation to his own mother; If you feel inferior because of bein g a woman; pregnancy may constitute a threat: 27/04/2008 marriage, or 5 CLE - Psychology V 60 Marriage & Pregnancy [Cont.] For the man who: Feel intense jealousy of the unborn child, and felt in relation to younger sibli ngs; Envy personal or professional success (in terms of family or social) of wom en, etc ... 27/04/2008 5 CLE - Psychology V 61 27/04/2008 5 CLE - Psychology V 62

Pregnancy and Regression Dominated Hypersomnia; Voracity; Protection. The oral characteristics that indicate a basic identification of pregnant towards the fetus. 27/04/2008 5 CLE - Psychology V 63 Pregnancy and Regression [Cont.] This identification countdown reached its climax, according to Otto Rank (1929), in the very process of delivery, when the mother relives the trauma of his birth. 27/04/2008 5 CLE - Psychology V 64 Pregnancy and Regression [Cont.] Here the regression is not necessarily a pathological process. Instead, it can b e part of the movement itself of the development process. 27/04/2008 5 CLE - Psychology V 65 Pregnancy and Regression [Cont.] Anna Freud (1965) sees the development as a temporary set of regressions The disease is characterized by permanent regressions. and progressions, using the model of the spiral 27/04/2008 5 CLE - Psychology V 66 Pregnancy and Regression [Cont.] This model is also implicit in the theory of crisis: To achieve a new level of personality organization - progression; You must go th rough a period of relative disorganization - regression. 27/04/2008 5 CLE - Psychology V 67 27/04/2008 5 CLE - Psychology V

68 Crisis pregnancy as [Cont.] Locate the pregnancy period as a crisis situation, obviously not to say that The critical period ends with the delivery; Much of the maturational changes occ ur postpartum. 27/04/2008 5 CLE - Psychology V 69 Crisis pregnancy as The puerperium should be considered: The continuation of the critical situation. Implies new changes: [Cont.] Consolidation of the physiological relationship mãebebé And big changes: 27/04/2008 Routines 5 CLE Psychology V 70 27/04/2008 5 CLE - Psychology V 71 System Family To emphasize that the birth of a child is a family experience. To provide an effective prenatal care is necessary not only support the "pregnan t woman" but "family pregnant." 27/04/2008 5 CLE - Psychology V 72 System Family [Cont.] One can consider that the family system as a whole, is composed of several subsy stems that interact continuously among themselves. 27/04/2008 5 CLE - Psychology V 73 System Family [Cont.] Howells (1972) considers the family as "a body that has a complete unit itself. As an individual, the family is also:

an organized system, with a peculiar structure, communication channels and 5 ele ments CLE - Psychology V characteristic. 27/04/2008 74 System Family [Cont.] Any event that occurs with part of this system affects the whole system. Therefo re, pregnancy is an experience that belongs to the family as a whole. 27/04/2008 5 CLE - Psychology V 75 System Family [Cont.] Even in a family composed of subsystems never represent a regnancy and until the first tion is extremely close, the a family triad. 5 CLE - Psychology V 27/04/2008 76 System Family For example: [Cont.] The man will react to the needs for greater protection and care that a woman wil l have to assume a protective role in living with her fears and anxieties relate d to childbirth and the postpartum period a portion to her the task of caring fo r the baby, she Experience with expectations and fantasies about the baby and th e same time that it produces within 5 CLE 77 04/27/2008 themselves their relatio nship PsicologiaaV child. with System Family [Cont.] This first triad family continues to remain stable, in that there is only one ch ild.€With the coming of each new child the whole composition of the network interco mmunication family becomes, as they add new subsystems that act dynamically betw een 5 CLE - Psychology V 78 itself. 27/04/2008 System Family [Cont.] father, mother and son true dyad, since from the moment it learns of the p weeks after delivery when the mother-infant interac husband-father participates actively forming truly

It is unfortunate that most research on the psychological aspects of pregnancy a nd childbirth are basically focus: on ways of experiencing pregnancy. 27/04/2008 5 CLE - Psychology V 79 changes in women's and devote little attention to fatherhood, as critical and in ter-influence of the couple System Family [Cont.] The reactions (attitudes and behavior) of man in relation to pregnant women grea tly influences their acceptance or rejection of pregnancy such as how will experience a whole range o f other changes (eg, CLE Psychology of the V alterações5 - 27/04/2008 scheme 80 System Family [Cont.] The attitudes of women in relation to her husband, will also influence the man i n particular: Encouraging him to participate to the fullest during and after pregnancy. Contri butes greatly to lessen or intensify the 5th of abandonment, feelings ciúmes81 CLE - Psychology V 27/04/2008 System Family [Cont.] Never be over-emphasized the interactions of the entire family unit in that each member of this unit undergoes significant changes under the impact of pregnancy . 27/04/2008 5 CLE - Psychology V 82