Prenatal and Perinatal Psychotherapy with Adults: An Integrative Model for Empirical Testing

By Lyman, B. J. | Journal of Prenatal & Perinatal Psychology & Health, Summer 2011 | Go to article overview

Prenatal and Perinatal Psychotherapy with Adults: An Integrative Model for Empirical Testing


Lyman, B. J., Journal of Prenatal & Perinatal Psychology & Health


Abstract: This article identifies an issue within the discipline of prenatal and perinatal (PPN) psychology, namely that the field currently consists of individual practitioners' modalities without empirical validation around treatment efficacy. The goal undertaken was to integrate the PPN literature related to adult psychotherapy into a coherent and practical model to serve as a guide for students and professionals that could also be empirically tested. Covered briefly is a review of the historical and pivotal literature, a description of theory, an assessment process, PPN treatment plan, techniques to facilitate access to PPN memories, and two illustrative excerpts from sessions as examples. Finally, suggestions for methodologically testing the model are offered.

Key Words: Prenatal, perinatal, adult psychotherapy, trauma, consciousness, intervention

Introduction

Despite the increase in prenatal and perinatal psychology (PPN) literature during the last quarter century, the field has not yet articulated an integrated PPN-specific model of psychotherapy with adults. What has developed are a number of individual practitioners' modalities, which have added a basic understanding and depth to our knowledge. However, few of these modalities integrate the building literature and none have been studied empirically. As the Program Chair of a graduate school, guiding students toward becoming PPN practioners, this situation is problematic. It is made more so by the fact that mainstream psychology has made a concerted effort to succinctly articulate graduate curriculums around a spécifie theory, which then guides the assessment process, treatment planning, and appropriate therapeutic techniques. This paper attempts to begin a discipline-wide conversation about what a PPN psychotherapeutic assessment and treatment plan might contain by offering a model that draws on the PPN literature. Also included in this model will be the more recent developments from a number of related disciplines that are currently impacting the clinical aspects of PPN therapy today, namely, the relational aspects of therapy from the neurobiology and attachment literatures, and a renewed emphasis on the importance of the body (somatic cues to early experience).

Definitions, Basic Assumptions, Limitations

Definitions

A definition for PPN psychology is that it views impactful events, which occur from conception through the prenatal and perinatal (birth) developmental time periods, as having profound and lasting psychological effects. PPN psychotherapy is defined as the treatment of the sequela of the deeply imprinted events, because without intervention unresolved early traumas have the potential to become maladaptive and repetitive patterns in adulthood.

Assumptions

This prenatal and perinatal paradigm's primary tenet is that the developing child is capable of sensing, experiencing, and remembering as a conscious, aware being, thus able to experience stressful events while in utero. That is, the prenate is conscious of the events experienced (especially those that are traumatic for psychotherapeutic purposes) and retains primitive imprints of events. These imprints will have cognitive, emotional, relational, and somatic (body) sequela as well that will continue into adulthood, and in all likelihood, if the early event was seen as intolerable or overwhelming by the unborn child, the memory of it will be forced out of consciousness.

Limitations

The literature review in this article is far from exhaustive, yet the reader is encouraged to explore the various topics listed, using the references as a guide if more depth within these topics is of interest. This review will not include the literature of the PPN therapeutic work with infants or children and their families. While the PPN assumptions are the same in working with this younger subset, developmental issues makes the infant/child model unique and will not be developed here. …

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