Several weeks ago, I learned that nineteen infants
have been brought to one of Florida’s designated Safe Haven,
which is either a hospital emergency room, fire station, or
EMS station. For any newborn up to three days old infant,
this option is a safe and anonymous solution, and for the
mother it offers immunity from criminal prosecution. Although
this Florida law has been on the book from two years, it seems
we are just in the beginning phase of informing our local
citizens. It is going to require continual grants, donations,
public service announcements, and twenty-four hour hotlines
to prepare the mental health community. We must educate school
administrators and teachers in learning how to raise public
awareness. All of which may well become the first line of
defense to help these troubled young girls before they engage
in their alarming solution to an unwanted pregnancy.
The question becomes, how could such an event happen,
especially in this day and age of nonstop 24 hours a day telecommunications.
Furthermore, over the past decade we have witnessed a remarkable
increase both in voluntary and involuntary exposure to provocative
and explicit sexual material on television, in movies, and
music videos as well as frank talk about abstinence and prevention.
Yet, ironically with all of the openness regarding sex education,
these young women have somehow transformed their sexual encounter
into an unspeakable taboo.
At this time, I’d like to begin with a brief historical
overview. Actually, there is much that could be integrated
starting with concepts from attachment theory, developmental
psychology including adolescent development, dissociative
disorders and trauma theory. I will restrict my talk today
to concentrate on the realm of the defensive mechanisms, to
highlight how these women behave in order to survive.
While killing one’s newborn is an extremely difficult
subject to comprehend, murdering an infant dates back to antiquity.
Reasons have included, “population control, illegitimacy,
inability of the mother to care for her child, greed for power
or money, superstition, congenital defects, and ritual sacrifice”
(Radbill, 1968). “Neonaticide, is defined as killing of a
neonate on the day of its birth.”
This term is differentiated from filicide which is
regarded as the murder of a child older than twenty-four hours
(Resnick, 1969). Primarily, for these young women the focus
has been on the sociological and legal aspects, with less
emphasis on contributing factors and underlying psychopathology.
These pathologies include the effects of childhood trauma,
including sexual abuse, the family constellation with its
dysfunction, and ways in which communication between members
becomes unconsciously avoided or colluded. In the latter scenario,
warning signs are not seen. In regard to the few clinical
case reports, symptoms cited included massive denial, psychoses,
and the dissociative disorders. Yet, the psychological research
literature has been quite sparse. Brozovsky & Falit (1971)
reported that in 1967,
45.7% of children murdered during the first year of
life were killed in the first 24 hours. One of the most important
reviews was conducted by Dr. Phillip Resnick. His article,
entitled Murder of the Newborn: A Psychiatric Review of
Neonaticide, reviewed the world literature on child murder
from 1951 to 1968, citing thirty-seven cases of neonaticide
compared to 138 cases of filicide. Dr. Resnick felt the primary
motivation for neonaticide was illegitimacy, or the fact the
child was unwanted, with denial of pregnancy a common accompaniment.
Dr. Resnick also identified two subgroups within his study;
the largest group being “sexually and emotionally immature
women, under strong social or parental pressure against an
illegimate child, who make no premeditated plans to kill the
infant following birth.” The second group consisted of “strong-minded
women who plan the death of the baby before it is born, with
little moral concern for their actions.” This study has been
confirmed by other researchers including
d’Orban (1979) and Wilkie, et al. (1982) although as
you can see these studies date back at least twenty years.
Why has this very deeply disturbing facet of human
nature not received as much attention? Perhaps, because it
is so rare. Yet as a society we too reenact the family trauma
and turn a blind eye in order not to see what needs to be
seen. What would lead a young mother to act with unimaginable
destructiveness and transgress the sacred realm of the infant-mother
dyad? Although it is hard to imagine, we need to try to comprehend
what factors lead to this terrible conclusion. What are the
unconscious factors and motivations? Or, what led to the loss
of rational thinking, the disinhibition and splitting of conscious
reality in order to engage in a delusional act? How could
what was conceived in a moment of romantic or idealized love,
heightened passion, or raw sexuality become subverted and
perverted in this twisted, and destructive persecutory fate?
One can certainly propose that there must me a myriad of reasons
leading a woman down this tormented path of separation, loss,
isolation and alienation, along with unbearable feelings including
anxiety, fear, shame, and guilt. What might constitute the
fears of these young women; is it the fear they will disgrace
and dishonor their families by acknowledging and exhibiting
their pregnancy? Is it their terrifying fear of rejection
and abandonment, that their family will be unsupportive and
unforgiving, abandoning them? If so, perhaps this is then
transferred and displaced onto the unborn child? Or, could
it be their disgust at themselves for losing self-control
and succumbing to unbridled temptation? Perhaps it is a result
of their utter rage that their bodies betrayed them for guilty
pleasure at the moment they wanted secrecy from their family
and world? Could cultural and religious factors heighten their
fears and hatred for this unplanned and unwanted outcome?
Perhaps some women yearning desperately for love, not realizing
their act for an idealized union could potentially lead to
procreation. Whatever their unconscious motivations were,
their mind’s defensive structure became solidified in such
a pathological manner that enabled these women to carry on
physically and psychically this painful burden for nine months.
And a secret so shameful and guilt-ridden that paradoxically
becomes both dissociated and consumed in their minds and bodies
waiting for the time when the fetus/object can be expelled.
No matter what the intrapsychic dynamics, early childhood
experiences, or repressed traumatic events as well as external
factors (i.e., unsupportive family relations, religious upbringing,
moral beliefs, etc.) somehow play a role in the resulting
disturbed phenomenology. They all converge into one overriding
reaction: which is what leads these women somehow all arrive
at a decision that their survival is based upon eliminating
or ridding themselves of their own infant.
And so, in the remaining time,
I would like to address the defense mechanisms as they give
insight and clues into the pathology and observed symptomatology
of these young women.
PRIMITIVE DEFENSE MECHANISMS:
These young women learn to live
with the tormenting horror of their unacknowledged act by
relying on a constellation of primitive defense mechanisms
as a way of coping with what they cannot bear. Defense mechanisms
protect or defend the individual against some kind of threat
or danger hence the term “defenses.”
In other words, these individuals need to defend against
some unacceptable or “repressed wish, idea, or feeling that
has been associated with some real or fantasized punishment”
(Moore & Fine, 1990). Additionally, due to the fact the
individual cannot bear the painful anxiety, shame, guilt,
or depression, these unacceptable thoughts and feelings are
kept from erupting into consciousness. Hence, the defenses
operate unconsciously, meaning there is no awareness these
are being employed to ward off the danger. The defenses I
will refer to today are considered “primitive” or less mature.
These less sophisticated defenses operate globally and “involve
the boundary between the self and the outer world.” (McWilliams,
1994); whereas the higher order defenses deal more with internal
boundaries (such as what is going on intrapsychically, between
ego and id or between the observing ego and experiencing ego).
The primitive defenses include denial, primitive withdrawal,
omnipotent control, repression, projection, and introjection,
and splitting. I will discuss each in the context of how they
are adapted to seemingly protect yet also alienate these young
women.
Denial – This
involves the refusal to accept what has happened. Here the
ego avoids conscious awareness of an aspect of reality because
it fosters too many unacceptable feelings. The persistence
of denying one’s pregnancy over nine month time frame constitutes
a serious problem. Ignoring the stark reality of one’s pregnancy
is very dangerous, as this entails not participating in prenatal
care, but also in regard to the absence of an emotional and
mental attunement to the developing fetus developing inside
the mother.
Repression – This
involves somehow expelling, withholding, or forgetting the
accompanying idea or feeling. What was once experienced is
now no longer in one’s conscious mind. For example, symbolically
delivering the baby could be unfortunately equated with the
desire that the mother finally was able to expel the unwanted
child (aka) perhaps perceived as a foreign object (it is put
in those terms, as the mother would be emotionally detached
from the infant’s humanness) and would finally be rid of what
she could not bear to think or feel.
Primitive Withdrawal
– Here the woman removes herself from social and interpersonal
situations, and instead retreats into a world of fantasy to
cope and self-soothe. Shrinking from personal contact may
be one of the hallmark characteristics of a defense used by
these women. Yet, hiding from the world forecloses the opportunity
to either ask for or receive help, but it does not eliminate
the problem. While these women may feel this is a necessity,
their reality becomes a distorted nightmare as these individuals
console themselves by retreating from others rather than reaching
out at a time when they need it most. Their fear that the
world is an unsafe place becomes reinforced as they wind feeling
all alone and unsupported.
Repression is
known as “motivated forgetting.” Doesn’t it make sense that
these women are indeed motivated to mentally expend a tremendous
amount of energy in order to forget their sexual encounter
and the resulting outcome. These individuals are tormented
and need a way to erase their past actions. Since they cannot
bear the harsh reality, they have to block all available memories
from consciousness.
Dissociation –
As reported in the literature, dissociation is an understandable
reaction to trauma. If someone has been traumatized or has
witnessed a life-threatening experience, the unimaginable
pain and/or terror experienced can prompt a dissociation.
We know young children learn to dissociate following repeated
incidents of abuse as it enables them to stop feeling the
emotional pain and overwhelming fear that accompanied the
event. In the context of being faced with an unwanted and
unacceptable pregnancy, the advantage of dissociation is obvious
as it cuts off the individual from the unbearable emotional
distress that otherwise would be experienced. However, being
dissociated from one’s feelings can greatly affect one’s personality,
and under extreme duress can lead to delusions, hysteria,
and possibly psychosis especially if contact with reality
is lost.
Projection can
be a difficult concept to explain, as it is subjectively experienced.
It is based upon a disowning of one’s attitudes to where they
are somehow seen or regarded as another’s perceptions and
beliefs. However, this is a gross misperception. In this context,
the pregnant woman may subjectively feel as if her unbearable
negative feelings of shame, guilt, dishonor are really coming
from others around her rather than realize the thoughts and
feelings are coming from within her own mind.
Introjection often
involves an indentification, and in this context, it is an
identification with an aggressor. By that, the young woman
tries to master her pain and feelings of fear and helplessness
by taking on qualities of some aggressive figure in their
life, and in doing so, redirects the anger and hostility against
herself as an unconscious self-punishment. It is as if the
woman feels she should suffer for what has occurred and she
deserves whatever emotional torment she puts herself through.
Here she treats herself the way she expects she would be treated
if discovered.
Splitting of the
ego is a fundamental defense mechanism as it is used as a
way to make sense of complex situations that appear both confusing
and frightening. Here the events are converted into situations
that are either “good” or “bad”. Being able to use this defense
is an effective way to reduce anxiety and maintain one’s self-esteem
(McWilliams, 1994). However, it also creates an unfortunate
disturbance and distortion, leading to all kinds of interpersonal
and intrapsychic problems.
Pathologically, what ensues in these circumstances,
is that the young woman feels herself either to be fragmented
due to not having a secure sense of self based upon prior
experiences in her life. Rather than being able to draw upon
her own emotional resources to ease her distress and become
her own source of support reassurance, she is unable to effectively
soothe herself. This is due to the events in her past where
caregivers either were unempathic, unpredictable, or emotionally
unavailable to help the individual adequately transform painful
experiences into adaptive ways of coping. Thus, one of the
conditions leading to the use of splitting as a defense is
the unavailability of an external support system that cannot
be internalized to provide a similar function.
CONCLUSION:
In this overview, it is hoped that you have a better
appreciation and understanding of the phenomenological characteristics
of these disturbed pregnant women based on theoretical evidence.
As you can see these individuals need to be treated with great
sensitivity and care since they would be very reluctant and
resistant to believe in the authenticity of a caring human
being who wishes to be of some help.
Therefore, in order to assist in the prevention of
infant mortality, we need to be proactive in raising the level
of public awareness. Teachers, neighbors, parents, friends,
mental health professionals, all need to take a more proactive,
yet sensitively attuned stance to enlist the trust and confidence
of these young girls. Foremost, these terrified females need
the protective guidance of another who can lend a helping
hand to extract them from the hell they have descended into.
Of course, the families need to be better educated regarding
the warning signs and communicating with their offspring about
sexual education and prevention. At this time, it is up to
other well meaning and caring individuals to come forward
and assist each deeply emotionally and mentally disturbed
young pregnant girl.
Furthermore, once the psychopathology is identified,
psychotherapy is essential as a tool to aid in assessing,
diagnosing, and treating the manifest symptoms and underlying
psychopathology. Once in treatment, the role of the family
needs to be incorporated in either family or marital therapy.
A component of the parent’s therapy can include outreach to
assist in their daughter’s prenatal care, parenting classes,
as well as helping her not forfeit her education; as well
as help her sort through and consider constructive alternatives.
Yet, in the absence of treatment, these young girls
who become pregnant, yet cannot accept this reality, are destined
to wind up in purgatory from which there is no escape.
REFERENCES
Brozovsky, M.,
& Falit, H. (1971). Neonaticide: clinical and psychodynamic
considerations. Journal of the American Academy of Child
Psychiatric, 10: 673-683
D’Orban, P.T.
(1979). Woman who kill their children. British Journal
of Psychiatry, 134: 560-571
McWilliams, N.
(1994). Psychoanalytic Diagnosis. Guilford Pres: New
York, NY. Pp.
96-115
Radbill, X. (1968).
History of Child Abuse and Infanticide. In Hefler, R.E. Kempe,
C.H., Eds.: The Battered Child. Chicago: University
of Chicago Press.
Resnick, P. (1970).
Murder of a newborn: a psychiatric review of neonaticide.
American Journal of Psychiatry,
126: 1414-1420
The American Psychoanalytic
Association (1990). Psychoanalytic Terms & Concepts.
Eds., B. Moore & B. Fine Eds. The American Psychoanalytic
Association and Yale University Press: New Haven, CT.
Wilkie, I., Pearn,
J., Petrie, G., et al (1982). Neonaticide: infanticide and
child homicide. Medicine, Science, and the Law,
22: 31-34
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