You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This paper is concerned with the part played by the earliest relationships with siblings in the development of a child's sense of identity. The eight year old boy whose psychotherapy is its main subject was born one of triplets following in vitro fertilization (IVF), a process which involved the culling of two unwanted embryos in the womb. Implicitly, the author questions the psychological approach to the parents and family adopted by the clinicians involved in IVF procedures. For this reviewer, however, the paper's main importance lies in the methodological questions it raises for analysts in the way we deal with the interface between the known and the unknown in clinical work.
IVF involves a major and often traumatic intrusion into what the author nicely terms ‘clair obscur de la grossesse’. The mystery of conception and gestation has been violated by knowledge of and deliberation about what is within the womb, and chance has given way to deliberation and intervention. The author emphasizes the destructive and negative aspects of this intrusion. For example, she surmises that the parents were unable to detoxify and so work through their own experience of violation by the IVF process, and that they coped with it by, in turn, violating their triplets’ space for fantasy by a naïve policy of ‘tell all’, in which the children were given full details, as soon as possible, of the process of their conception - including the culling of their two siblings in utero.
Science has given us another means besides IVF of penetrating the mystery of intrauterine life, in the form of ultrasound imaging of the foetus. The author treats this as a benign form of intrusion, and a brief report of Piontelli's (1992) major study of in utero infant observation is included in her paper. She draws from Piontelli's conclusions to help elaborate how the presence of siblings, alive or dead, in the womb might influence the development of a child's sense of identity. Specifically, she speculates that