A longitudinal examination of the psychic world in transition to motherhood: Pregnancy, birth, and meeting the baby

In this doctoral thesis, the transition of first-time mothers to motherhood was analyzed through semi-structured clinical interviews and projective tests applied longitudinally at different stages of this process. The theoretical background of the study is based on psychoanalytically-oriented studies on the perinatal period and early mother-infant relationship. Based on their professional experiences and clinical observations, many clinicians and theorists with a psychoanalytic orientation agree that pregnancy and childbirth reveal psychic processes specific to this period. However, there are very few studies that operationalize these observations in a research setting. In this study, 17 primigradiva women were administered the Rorschach test and TAT during the first trimester and the third trimesters of pregnancy, as well as the first three months and the first year postpartum. In addition to the projective tests, they were interviewed clinically during the last trimester of the pregnancy as well as the first three months postpartum. At the end of these sessions, the findings obtained from Rorschach Test were compared both between sessions and with the findings of an equivalent sample from the Turkish Rorschach Adult Norm Study. In addition, the clinical interviews, the Rorschach Test, and the TAT responses were subjected to content analysis with a psychoanalytical perspective. The first hypothesis of the present study is that the transition to motherhood will change the psychological functioning in a unique way. It was expected that these changes would be shaped around certain preoccupations specific to each stage in the motherhood process. The findings of the study point to a dynamic psyche-soma dialectic and the central position of representations around "body" in the perinatal period. The perinatal period begins with bodily and narcissistic investments to a large extent. The pregnancy period also demonstrates the permeability of bodily boundaries, the work of symbolizing the 'unknown' and the 'formless', and the disorganization of thought processes. Clinical interviews and the TAT findings point to a 'psychic transparency' in the later stages of pregnancy, which is described as "narcissistic polarization and permeability that occurs with a decrease in the usual defenses against repressed unconscious material" (Bydlowski and Golse, 2001). In both clinical interviews and projective tests, the period after birth seemed to be characterized by "primary maternal preoccupation" (Winnicott, 1956). Concerns about bodily integrity decreased compared to the pregnancy period, but was still high compared to the norm sample. By the end of the first year postpartum, it was observed that psychic transparency and primary maternal preoccupation lost their impact on psychic functioning and thought processes of the participants to a large extent. However, it was found that the effort to strengthen the boundaries of the body and the work of 'objectification' was still continuing during the one-year period following the birth. The second hypothesis of the present study is that the process of transition to motherhood involves the revival of important conflicts in the formation of the human psyche. In accordance with this hypothesis, both the works on separation-individuation and oedipal re-structuring were found to be inherent in this process and were still vividly present at the end of the first year. The longitudinal nature of the study contributed to our understanding of how all these processes are in a sequential flow, how psychic transparency prepares future mothers for identification with their babies, and how primary maternal preoccupation provides a basis for the facilitation of early maternal functions. This study has aimed to provide a general framework of how the perinatal period is experienced in the normal population. Studying with normal population allows us to understand the complex dynamics of the perinatal process and thus to better comprehend the conflicts underlying the possible difficulties.It is hoped that this thesis and future perinatal studies will help us understand the function of the changes in psychic world both for the mother and the mother-infant bond and contribute to making sense of the 'strange' experiences of this process without pathologizing it. Keywords: Motherhood, Pregnancy, Perinatal Period, Longitudinal Research, Rorschach, TAT, Psychic Transparency, Primary Maternal Preoccupation.