Under the heading 'Primary Maternal Preoccupation' I have referred to the immense changes that occur in women who are having a baby, and it is my opinion that this phenomenon, whatever name it deserves, is essential for the well-being of the infant.
It is possible to provide good initial care, but to fail to complete the process through an inability to let it come to an end, so that the
For a more detailed statement on this point see ‘Primary Maternal Preoccupation’ (1956).
I call it ‘primary maternal preoccupation’. This is not necessarily a good name, but the point is that towards the end of the pregnancy and for a few weeks after the birth of a child the mother is preoccupied with (or better, ‘given over to’) the care of her baby, which at first seems like a part of herself; moreover she is very much identified with the baby and knows quite well what the baby is feeling like.
Margaret Ribble (1943), who enters this field, misses, I think, one important thing, which is the mother's identification with her infant (what I call the temporary state of Primary Maternal Preoccupation). She writes:
The human infant in the first year of life should not have to meet frustration or privation, for these factors immediately cause exaggerated tension and stimulate latent defense activities.
Under the heading ‘Primary Maternal Preoccupation’ I have referred to the immense changes that occur in women who are having a baby, and it is my opinion that this phenomenon, whatever name it deserves, is essential for the well-being of the infant.
(London: Tavistock; New York: Basic Books, 1958) includes: A Note on Normality and Anxiety (1931)
Fidgetiness (1931)
Appetite and Emotional Disorder (1936)
The Observation of Infants in a Set Situation (1941)
Child Department Consultations (1942)
Ocular Psychoneuroses of Childhood (1944)
Reparation in Respect of Mother's Organized Defence against Depression (1948)
Anxiety Associated with Insecurity (1952)
Symptom Tolerance in Paediatrics: a Case History (1953)
A Case Managed at Home (1955)
The Manic Defence (1935)
Primitive Emotional Development (1945)
Paediatrics and Psychiatry (1948)
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Birth Memories, Birth Trauma, and Anxiety (1949)
Hate in the Counter-Transference (1947)
Aggression in Relation to Emotional Development (1950)
Psychoses and Child Care (1952)
Transitional Objects and Transitional Phenomena (1951)
Mind and its Relation to the Psyche-Soma (1949)
Withdrawal and Regression (1954)
The Depressive Position in Normal Emotional Development (1954)
Metapsychological and Clinical Aspects of Regression within the Psycho-Analytical Set-Up (1954)
Clinical Varieties of Transference (1955)
Primary Maternal Preoccupation (1956)
The Antisocial Tendency (1956)
Paediatrics and Childhood Neurosis (1956)
The Child, the Family, and the Outside World.
Another feature of the quality of attention demanded from the analyst by the patient in a regressed state can be best described in terms of what Winnicott has called “primary maternal preoccupation” (1956a).
If the mother provides a good enough adaptation to need, the infant's own line of life is disturbed very little by reactions to impingement.
The function of holding is natural to a mother from her Primary Maternal Preoccupation (Chapter XXIV below) and is based on maternal empathy rather than on understanding.
In the case of one patient in whose analysis there was a particularly good opportunity to watch the birth process, since it was relived repeatedly, I
I now call this special state of sensitivity in the mother ‘Primary maternal preoccupation’, 1957. (See Chapter XXIV.)
When a woman has a strong male identification she finds this part of her mothering function most difficult to achieve, and repressed penis envy leaves but little room for primary maternal preoccupation.
In practice the result is that such women, having produced a child, but having missed the boat at the earliest stage, are faced with the task of making up for what has been missed.
Indeed a recognition of absolute dependence on the mother and of her capacity for primary maternal preoccupation, or whatever it is called, is something which belongs to extreme sophistication, and to a stage not always reached by adults.
We can now say why we think the baby's mother is the most suitable person for the care of that baby; it is she who can reach this special state of primary maternal preoccupation without being ill. But an adoptive mother, or any woman who can be ill in the sense of ‘primary maternal preoccupation’, may be in a position to adapt well enough, on account of having some capacity for identification with the baby.
For this reason the individual needs to start in the specialized environment to which I have here referred under the heading: Primary Maternal Preoccupation.
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The mother who develops this state that I have called ‘primary maternal preoccupation’ provides a setting for the infant’s constitution to begin to make itself evident, for the developmental tendencies to start to unfold, and for the infant to experience spontaneous movement and become the owner of the sensations that are appropriate to this early phase of life.
Indeed a recognition of absolute dependence on the mother and of her capacity for primary maternal preoccupation, or whatever it is called, is something which belongs to extreme sophistication, and to a stage not always reached by adults.
We can now say why we think the baby’s mother is the most suitable person for the care of that baby; it is she who can reach this special state of primary maternal preoccupation without being ill. But an adoptive mother, or any woman who can be ill in the sense of ‘primary maternal preoccupation’, may be in a position to adapt well enough, on account of having some capacity for identification with the baby.
For this reason the individual needs to start in the specialized environment to which I have here referred under the heading: Primary Maternal Preoccupation.