Empathic psychotherapy for pregnancy termination for fetal anomaly.

Pregnancy termination for fetal anomaly is a unique reproductive loss with many issues distinct from spontaneous pregnancy loss, as typically addressed in the current literature. After providing a brief overview of this loss and the impact of stigma, some of the therapeutic tasks particular to this loss will be identified, including absorbing the impact of learning about the anomaly, defining what or who has been lost, deciding whether to continue or terminate the pregnancy, and deciding who to tell what. These therapeutic tasks are discussed using the available research literature, but primarily illustrated through clinical vignettes and therapist-client dialogue. Therapeutic empathy will be demonstrated as both an instrument of healing in itself, as well as a means of realizing other therapeutic goals and interventions such as empowerment, normalization, validation and processing grief and trauma, all crucial elements of doing therapy with this population. Contrasting perspectives of this loss in therapy and the role of the therapist are discussed. (PsycINFO Database Record

Understanding and treating infertility: psychoanalytic considerations.

This article describes how the intrapsychic, psychosocial, and social ramifications of infertility may be addressed when infertility patients present with distress at the psychotherapist's office. Self psychology provides a valuable framework for the therapist, given the profound and multiple narcissistic assaults on self-esteem, consolidation of identity, developmental aspirations, and other self attributes which infertility causes. The therapist's empathy becomes the primary tool of both understanding and alleviating suffering resulting from infertility. The current medical and interpersonal experiences of the infertile person must be part of the therapeutic process. A psychodynamic model of treatment is outlined which includes goals of reestablishing narcissistic equilibrium, diminishing internalized stigma, and ameliorating other adverse psychological consequences of infertility diagnosis and treatment.

Adoption losses: naturally occurring or socially constructed?

The American definition of kinship based on biological ties, the practice of closed adoption, and stigmas associated with adoption may decisively influence adoption-related losses. Cross-cultural and historical accounts of adoption that do not apply to these contemporary American constructs of parenthood and practices of adoption suggest outcomes that are not as integrally based on loss. Adoption in infancy is defined as parenting a child with one set of (adoptive) parents and two (adoptive and birth) families. Implications for adoption research, policy, and practice are discussed.