The Setting: To Be in Touch

I think it should be borne in mind that the following observations, made in various Neonatal Intensive Care Units (NICUs) in this country and in the United States, have taken place at a time when the medical profession realizes that in many respects the technology which made such spectacular advances and often left psychological considerations far behind seems to have reached its limits, so that there is time to pause and take stock. Concurrently, powerful social forces are questioning the authority of the hospital over its patient population. Moreover, competition for who “owns” the patient is gradually being replaced by considerations of how hospital and family can best complement each other to help the patient to help himself.

There is no doubt that the current hospital setting is still inhibiting and discourages mothers from having close physical contact with their babies. As one mother put it, when talking about her newborn: “When I get home I'll put him on the floor and I'll get to know him at last”.

Both hospital staff and mother (for short, I use “mother”, as she is the main caregiver) manifestly have the same aims: 1. that while the baby is in neonatal intensive care the mother should be helped to become confident in looking after him herself, and 2. that mother and infant should thrive so that they can be at home together as soon as possible. In fact, however, we often encounter somewhat puzzling manifestations that do not bear out this identity of interests. They begin to make sense only if we acknowledge the double-edged nature of the conscious and unconscious functioning in both staff and parents.

On a surface level we can discern the rational well-meaning intentions of hospital staff, but underneath staff have to distance themselves to cope with anxieties and conflicts over possessiveness and loss of authority. Similarly, mothers are manifestly motivated to be in frequent close physical touch with their infants, especially after having been separated from