Discussion of Joshua M. Perman's Article, Multiple Pregnancies in Multiproblem Families: The Chronic Postpartum Reactions

I found Dr. Perman's paper most interesting. I strongly believe that psychoanalysis can be very useful for better comprehension of social phenomena and that investigations such as Perman's can yield fruitful results. I discussed this paper with some psychoanalytic colleagues and social workers; they all agree the problems described by Dr. Perman are the same as those existing here in Uruguay.

I concur with the author on the relationship between defects in individuation, crowding, multiple pregnancies, and multiproblem families. I also find sound his hypothesis that mother-child symbiosis should be reckoned as a factor when one considers the problems which afflict these families.

But I differ with him on the methodological approach to the problem. In my opinion, the findings of psychoanalysis in the field of bipersonal relationships are only valid for that field. If we refer them to the field of social phenomena—the family group for instance—these findings cannot have the same significance.

As Dr. Perman shows clearly in his clinical material, these findings do appear in the social field as well; but they appear in a different context and have a different meaning. They lose the primordial significance they have in the field of bipersonal relationships and become secondary. They do not provide a sufficient explanation in a social context.

Group psychoanalysis must establish its own theories and have its own viewpoints arising originally from work in social microgroups. The hypotheses should originate in the consideration of the group itself and of intergroup relations, and not merely by applying to a group the findings of bipersonal psychoanalysis.

From this point of view, we soon find, when approaching a social group, that the illness is a group illness, not a bipersonal or individual one.

Dr. Perman starts along these lines when he maintains that an important determinant of the social isolation and crowding of these families is the phobic organization of their lives;