So the Cradle Won't Fall: Holding the Staff who Hold the Parents in the NICU

In this article I present the challenge and privilege of serving as consultant in a neonatal intensive care unit (NICU). Working in a NICU means a daily confrontation with brutal emotional realities, yet the demands of an intensive medical setting do not allow for much reflection on the raw feelings so often experienced. The staff may resort to primitive defenses to survive unbearable anxieties; as a result, feelings may be evacuated or deadened and thoughts crowded out. The staff's ability to understand and deeply empathize with families of these critically ill newborns is frequently compromised. Finding a way to keep a feeling and thinking psychoanalytic self alive in such an atmosphere is its own challenge; bringing that self forward to develop relationships with staff that allow space for thought and containment of distress, and lead to better holding of the parents' experience, is even more complex. I elaborate my efforts to respond to the staff's ambivalent hunger for emotional support, and I describe the ways in which close collaboration with my psychoanalytic colleague are crucial to making sense of and to containing the emotional chaos and projective processes so common to both the staff's and my experience in this setting.