In these days of commonplace contraception and the prolongation of higher education, adolescent pregnancies appear as a challenge to the socially-prescribed reproductive period and generally give rise to worry and incomprehension. The object of this article is to show how scientific discourse helps to reinforce the socially required age of first pregnancy. Contrary to a medicalized and normative literature, this article will also, on the basis of field studies, call into question some received ideas on the subject, and outline some other explanations for these « culturally » precocious pregnancies.
Clinical practice in a maternity ward highlights essential prenatal psychological elements in the perinatal segment of the parenthood process.
Faced with the multiplied uncertainty about how the unborn child will turn out, prenatal parental anticipation is a determining factor. It deserves to be explored in perinatal clinical work as a relevant psychological and psychopathological marker.
In this context, the concept of « virtual object-relation » tries to explore the behavioral, emotional and fantasmatic complexity of the parents/fetus relation and its reappearances, throughout life, at the time of metamorphoses whose outcome is uncertain, such as adolescence.
The mother-baby relation corresponds for both to a trap in which the time of development shuts down. Our observations of dyads we were close to in nursery, mother-baby center and pediatric care settings argue in favor of a characteristic mother-baby distance disorder. The infant is invested as a « transition object », used by the mother as transitory support for her parental imagoes in the course of de-idealization, within an unaccomplished post-adolescent process. This results in a behavioral and emotional « house arrest » for the baby, which will have to conform to maternal expectations if it wants to be spared the abrupt experience of defensive withdrawal of maternal investment. Caught between idealization and refusal, the baby experiences early conflict only in its aspect of rupture, which causes a problem for the construction of its subjectivity.
Here we study the question of the bond between mother and daughter. In some of its occurrences, it uses the fertility as a support.
The words of three teenagers and their mothers concerning the occurrence of a « surprise » pregnancy and the wish to terminate it shows us a singular form of passage by the flesh which nourishes itself on an organizing originating fantasy: that of a undifferentiated collective matrix, the Magmamatrice.
In order to explore the coincidence of these two forms of identity crisis, adolescence and motherhood, two hypotheses are offered: one dealing with the cultural factor in the avoidance or facilitation of psychopathological disorders ; and the second considering pregnancy and motherhood as antinomic with regard to adolescent processes. These lines of thought are developed in three parts. The first, which is based on an interview with Inès, a young mother of gypsy origin, helps one to understand how the cultural space, shared with the outer social world, lends itself to bearing the inner psychical world. In the second part, pregnancy’s resistance to adolescent processes are dealt with through the novelties of the pubertaire and narcissitic issues. In the third part, we present the treatment of a pregnant adolescent and her family within the setting of a multidisciplinary parenthood support network.
Using his experience of specific psychiatric consultation for adolescents at the Geneva Maternity Hospital, the author offers some thoughts on pregnancy in adolescence, the psychical transformations that it conditions, and the work around the proposal that the pregnancy be terminated. The place of the girl’s parents and that of the adolescent father are also treated. The desire for a child in adolescence is treated with reference to the girl’s history and her future.
The family’s reconstruction occasions numerous individual and group changes. These changes touch particularly upon parenthood. In the past family reconstitution occurred after a death and achieved a substitute family. Now it achieves an additional family and the child finds himself confronted with a real « parental constellation ». It often induces him to play an active part in the complex games the grown ups are practicing.
So when he leaves one parent to live with the other, the adolescent revives the old game played between the separated partners. At the same time, his new presence within the reconstituted household strongly tests the marital life of the new couple.
A crisis develops all the more in that the tensions are more often acted than thought. It has consequences on the therapeutic interventions, which are essentially based, at least initially, on a relational classification which must be quick and brief. In fact there is a great risk of the family shattering and of a new separation.
In developed countries, adopted children represent less than 1% of births, but may represent over 20% of the patients in mental health services. This imbalance raises the question of the relationship between adoption and psychopathology, and more precisely between adoption and suicide crisis in adolescence.
Based on a review of the scientific literature and on her own clinical experience, the author offers some psychodynamic hypotheses and points out potential directions for reflection upon this problematic.
The solidity of adoptive filiation is gauged when tested by the identity mutations proper to adolescence. The parental setting is much solicited in its function of containing and of transforming adolescent anxieties. The path which has led to the child-turned-adolescent is then re-interrogated to test the originating imaginary world of the couple in its historicizing role. We will discuss the reasons for the psychical vulnerability of adoptive filiation, and the similarities between filiating process and adolescent process. On the parents’ side, one difficulty is represented by the inability to make a connection between the child in his pre-adoptive history, marked by abandonment and affective deficiencies, and the continuity of their own family history.
The clinical experience of facilitating support groups for parents of adolescents leads to thoughts which, starting from the group dynamic and what settles into it, allows us to formulate a range of hypotheses about the psychical impact produced in the parent by his child’s attainment of adolescence. Here the group is conceived of as a possible place for opening and symbolization where the protagonists question each other and carry on a common psychical work on these implications.