Medical and Nursing Staff at Risk:
Very Early Prevention of
Psychosomatic Illness in Infancy
Michel Soulé, M.D.,
The increased understanding of psychosomatic illness in infancy has made it clear that preventive measures need to be taken at increasingly earlier stages and should include the infant and both parents. Intervention should focus on the newborn, on the fetus, on the pregnancy, on the conditions of fertilization and generation by the parents, and finally on the adolescence of future parents. It is now better understood that there are crucial interactions on a real, interpersonal level and on the level of fantasy between the infant and its parents, as well as between the parents themselves. It is perhaps less well appreciated that these interactions involve a third "partner," for in addition to the infant and the parents, there is the medical and nursing staff who play an active role at all stages in this period of life, becoming progressively more involved with these real and fantasy interactions in many and complex ways. The staff participants include all personnel, including receptionists.
It is common knowledge now that there have been vast changes in family life and in the way couples live together. These changes, together with the fact that there is a comparatively small number of children in kinship groups, affect a young woman so that she cannot summon memories of childhood experiences to use in maternal identifications, or as a basis for intuitively sensing a reciprocal relationship with her child, or to plan maternal tasks in a confident and flexible way. In addition, at certain times during the pregnancy and after delivery, most mothers must confront anxiety, regression, and dependency in relation to whatever images of maternal functioning they possess. At these times the mother is much more sensitive to external interventions by anyone—man or woman—who provides actual treatment or assistance, and who at the same time embodies parental images and is therefore vested with all the concomitant emotional burdens. Consequently, this interaction also takes place on the level of fantasy between two individuals, one of whom, the mother, has recently undergone considerable change in psychological status. While the interaction between adults has aspects comparable to the interaction between mother and infant, it functions on a different plane.
The mother's fantasy life has been unconsciously affected by her pregnancy and by the birth and the proximity of the baby. Of course,