On the Transformation of Early Narcissism During Pregnancy1

Zilboorg (1929), (1938) has shown that certain pregenital fantasies are of specific etiological significance in the genesis of post-partum psychosis. Murray (1960) has stressed the importance of early untransformed narcissism in the etiology of reactive depression. The case under discussion clearly illustrates how fantasies of narcissistic entitlement to primitive wish fulfilment may activate post-partum depression. The theme of this discussion is the effective psycho-analytic transformation, during pregnancy, of this early narcissism and these pregenital fantasies. The paper is a study in psycho-analytic preventive medicine.

Literature

Zilboorg (1929) writes that women who develop schizophrenic illness after childbirth have had unusually happy and symptom-free pregnancies, in contrast to the neurotic problems often present during the pregnancies of normal or mildly neurotic women. His patients suffered from a persistence of serious narcissistic needs and consequently had never adequately solved the problem of their penis envy. Like normal women, they had envied their fathers' penises and had retained a deep sense of inadequacy. The problem of the oedipal attachment was solved by the fantasy of obtaining a penis through fantasied pregnancy with the father's child. Pregnancy, therefore, means the fulfilment of this fantasy. But delivery means the loss of the father's penis, a narcissistic blow of such severity as to precipitate a psychotic break in such narcissistic women. Characteristically, these women show lack of interest in their babies because the babies have lost their special significance in relation to pregenital narcissistic entitlement and have minimal significance as reality objects. In a later paper (1938) Zilboorg writes that the fantasied castration brought about by the birth of the child who is equated with the penis is a repetition of the narcissistic injury suffered at weaning and even at each withdrawal of the breast. Freud's