The Experience of Pregnancy for One Expectant Father and His Patient

To describe the perspectives of expectant mothers and fathers on fathers' involvement during pregnancy. Becoming a father is a major life event and paternal involvement during pregnancy has a positive influence on the family. However, research into both expectant mothers' and fathers' perspectives on fathers' involvement during pregnancy is relatively scarce. A descriptive qualitative study was used. Thirty expectant parents (20 women and 10 men) were interviewed either as part of one of four focus groups or in an individual interview. Qualitative content analysis was performed on the interview transcripts. A theme of 'Paddling upstream' emerged as an expression of the latent content of the interviews concerning perspectives on fathers' involvement. Five sub-themes described the manifest content: trying to participate, trying to be understanding, trying to learn, trying to be a calming influence and trying to find a balanced life. Expectant parents suggested several ways to improve fathers' involvement and to meet parents' need for shared involvement. Expectant mothers and fathers wanted the father to be more involved in the pregnancy. Although fathers attempted different strategies, they did not always perceive what was expected of them and encountered many barriers as they tried to navigate through this unique experience. The best support for the father was the mother. Expectant parents wanted their healthcare to include the father more thoroughly and to focus on the whole family. Prenatal care professionals can overcome barriers that prevent paternal involvement. Although fathers are not able to engage in the pregnancy on the same level as the mother, we suggest that their specific needs also be recognised through an increased awareness of gender norms in healthcare.

Objective: To synthesise qualitative study findings in order to gain an understanding of fathers’ experiences of pregnancy. Background: As the transition to fatherhood can be challenging, awareness of the factors facilitating or hindering expectant fathers’ adjustment is important. Our aim was to better understand the experiences of men during this significant life cycle phase, and to use this knowledge to advise health care professionals on how best to support men during this transition. Methods: We used Noblit and Hare’s metasynthesis approach to review and synthesise 13 qualitative studies relating to expectant fathers’ experiences of pregnancy. Results: The synthesis revealed five super-ordinate themes, which captured the emotional, psychological and physiological experiences of the expectant fathers during pregnancy: (1) Reacting to early pregnancy; (2) On the outside looking in; (3) The pregnant male; (4) A journey of acceptance; and (5) Redefining self as a father. Conclusion: Possible clinical implications and limitations of the metasynthesis approach are discussed. Relevant recommendations on how health professionals and services can be more effectively supportive of men during this period are outlined.

BackgroundSmoking cessation during pregnancy and the postpartum period by both women and their partners offers multiple health benefits. However, compared to pregnant/postpartum women, their partners are less likely to actively seek smoking cessation services. There is an increased recognition about the importance of tailored approaches to smoking cessation for expectant and new fathers. While Behavior Change Interventions (BCIs) are a promising approach for smoking cessation interventions, evidence on effectiveness exclusively among expectant and new fathers are fragmented and does not allow for many firm conclusions to be drawn.MethodsWe conducted a systematic review on effectiveness of BCIs on smoking cessation outcomes of expectant and new fathers both through individual and/or couple-based interventions. Peer reviewed articles were identified from eight databases without any date or language restriction.Two independent reviewers screened studies for relevance, assessed methodological quality of relevant studies, and extracted data from studies using a predeveloped data extraction sheet.ResultsWe retrieved 1222 studies, of which 39 were considered for full text screening after reviewing the titles and abstracts. An additional eight studies were identified from reviewing the reference list of review articles picked up by the databases search. A total of nine Randomised Control Trials were included in the study. Six studies targeted expectant/new fathers, two targeted couples and one primarily targeted women with an intervention component to men. While the follow-up measurements for men varied across studies, the majority reported biochemically verified quit rates at 6 months. Most of the interventions showed positive effects on cessation outcomes. BCI were heterogenous across studies. Findings are suggestive of gender targeted interventions being more likely to have positive cessation outcomes.ConclusionsThis systematic review found limited evidence supporting the effectiveness of BCI among expectant and new fathers, although the majority of studies show positive effects of these interventions on smoking cessation outcomes. There remains a need for more research targeted at expectant and new fathers. Further, there is a need to identify how smoking cessation service delivery can better address the needs of (all) gender(s) during pregnancy.

Childbirth fear in expectant fathers: Findings from a regional Swedish cohort study

A qualitative investigation into the pregnancy experiences and childbirth expectations of Australian fathers-to-be

Psychologic Involvement in Pregnancy by Expectant Fathers

How can reading literary fiction shed light on the way we speak ourselves within psychoanalysis? Rather than offering psychoanalytic insights into literature, Rosemary Rizq, a practicing psychologist and psychoanalytic psychotherapist, explores what literary fiction can bring to psychoanalysis. In this fascinating collection of essays, she draws on stories written by authors ranging from Henry James to Kazuo Ishiguro and Colm Tóibín. By investigating the possibilities for ‘fruitful encounter and dynamic exchange’ between psychoanalysis and literature, Rizq sets out to offer a fresh perspective on theoretical ideas that are often presented within the psychoanalytic literature in abstract, overly technical ways. In a remarkably fresh approach, this book explores how fiction can inform, illuminate and even transform our understanding of psychoanalysis. Written for practicing clinicians, academics and students as well as for the wider public, this book offers an original and revealing perspective on the overlapping knowledge-claims and concerns of both literary fiction and psychoanalysis.

An effort has been made to develop a critical overview of current advances in the psychoanalytic explorations of culture and evolution. The paper delineates some of the basic propositions of Darwinian and neo-Darwinian evolutionary theory, especially those that are pertinent to psychoanalytic investigations. It then attempts to critically evaluate the psychoanalytic literature that has been developed on the basis of these propositions. While acknowledging that these are bold and inventive ventures into new domains that in time are likely to greatly expand and enhance psychoanalytic thinking, the paper discusses some major problems with the methodology and thinking that characterizes this work. Among these troublesome concerns is the tendency of these analytic investigators to rely too heavily on animal data for their thinking about the human psyche and its interactions. There is as well a related failure to deeply appreciate the emergent properties of the human mind. It is suggested that this work needs to be grounded in a clear set of basic units of mental structure and functioning lest the adaptationist programs and theoretical ideas that are developed be badly flawed. Because this work has such great potential, it is hoped that the issues and matters for debate raised in the present paper will lead to fruitful discussion and to a more solid foundation for these imaginative pursuits.

Something that happened to one of the authors recently led them to re?ect upon what the analyst's falling ill may represent and the problems it may give rise to in the analytic relationship. Such an eventuality injects a massive dose of the analyst's personal reality into the analytic space, thereby allowing the patient a glimpse of images of vulnerability, frailty and loss, and mobilizing emotions, fantasies and defences in both the analyst and the patient. The authors' survey of the literature ranges between two different theoretical perspectives intrapsychic and inter-subjective that, in their most radical formulations on technique, call for maintaining either the strictest neutrality and anonymity or symmetrical relationality. In both cases, that which is denied is the unconscious communication that enables the analyst, irrespective of his conscious intentions, to allow either parts of himself or inner objects of the patient to act in the relationship. In closing, the authors shall illustrate the concept discussed through three clinical vignettes.

Something that happened to one of the authors recently led them to refl ect upon what the analyst's falling ill may represent and the problems it may give rise to in the analytic relationship. Such an eventuality injects a massive dose of the analyst's personal reality into the analytic space, thereby allowing the patient a glimpse of images of vulnerability, frailty and loss, and mobilizing emotions, fantasies and defences in both the analyst and the patient. The authors' survey of the literature ranges between two different theoretical perspectives intrapsychic and intersubjective that, in their most radical formulations on technique, call for maintaining either the strictest neutrality and anonymity or symmetrical relationality. In both cases, that which is denied is the unconscious communication that enables the analyst, irrespective of his conscious intentions, to allow either parts of himself or inner objects of the patient to act in the relationship. In closing, the authors shall illustrate the concept discussed through three clinical vignettes.

Understanding Dissidence and Controversy in the History of Psychoanalysis

Separateness and closeness as expressed in Bird’s Nest Drawings: Relationships with partners and with the unborn child among expectant parents

The association between adult representations of early attachment relationships and history of individual and family mental health was examined in a sample of 233 expectant mothers and fathers. As predicted, security of attachment was linked to mental health. Parents classified as Preoccupied were more likely than other parents to report suicidal ideation. Whereas parents classified as Unresolved more often reported suicidal ideation, emotional distress, and substance abuse. With respect to family history. Unresolved and Preoccupied attachment classifications were significantly related to child abuse involving a relative and parental separation or divorce. These findings support theoretical conceptualizations regarding the link between adult attachment and mental health in middle-class American adults.

By now the internet and other forms of virtual communication have been in place for at least twenty years. However, surprisingly little has been written about the use of new technologies in the psychoanalytical literature. As such, Psychoanalysis in the Technoculture Era is a timely exposition on the subject of both virtual and analytic space. Bringing together the work of several psychoanalysts, the Editors Alessandra Lemma and Luigi Caparrotta illustrate how new technologies have become an integral part of our everyday lives and how they have silently and subtly permeated the psychoanalytic setting. The contributors explore how new technologies have affected psychoanalytic practice and discuss the advantages and disadvantages of its use. Psychoanalysis in the Technoculture Era unravels some of the meanings of virtual world terms, and opens this field to greater scrutiny, stimulating and promoting discussion about new technologies in psychoanalytic practice. This book will be of interest to the psychoanalytic community including psychotherapy professionals, psychoanalysts, post graduate, graduate and undergraduate students.

Tiresias and His Trouble with Ambiguity in Gender Marco Posadas (bio) To begin, I would like to identify my position as chair of the Sexual and Gender Diversity Studies Committee of the International Psychoanalytical Association (IPA). The IPA is the first, oldest, and largest international psychoanalytical association in the world. It was created by Freud with the help of Ferenzci, Jung, Eitington, Abraham, and Jones in 1910 with the purpose of organizing what started to be a body of theory and clinical mental health practice, and for the promotion of scientific activities at an international level. Today the IPA has almost fourteen thousand members and more than six thousand candidates within three consolidated regions—North America (including China, Korea, and Japan), Europe (including New Zealand, Australia, India, and South Africa), and Latin America—and a new, fourth region, Asia, which hopes to consolidate China, Korea, Japan, India, New Zealand, and Australia. It organizes a biannual international congress that is one of the largest psychoanalytic events in the world. The IPA has four official languages—English, French, German, and Spanish—and more than fifty languages among all its constituent psychoanalytic societies and institutes. A large part of its organizational and scientific work is divided, planned and executed by committees. Committees are appointed by the executive committee and ratified by the IPA board. The committee I chair was appointed by Stefano Bolognini's administration in June 2017. Our committee is fortunate to continue to be strongly supported [End Page 93] by Virginia Ungar, the first female president of the IPA, and Vice President Sergio Nick's administration. Before the creation of the Sexual and Gender Diversity Studies Committee, during its planning stages, there was already a lot of ambiguity around addressing issues of gender and sexual diversities in psychoanalysis. An important part of the committee's mandate is to create spaces for IPA-affiliated psychoanalysts and candidates and for non-IPA-affiliated psychodynamic clinicians and psychotherapists, among an increasing number of people interested in psychoanalysis, to discuss issues pertaining to psychoanalytic clinical theory and practice and to the intersection of sexual and gender diversity. Although our committee had anticipated the resistance that has been historically present when addressing these types of topics in psychoanalytic institutions (Drescher 2008; Roughton 1995, 2002), we were not able to identify and agree upon a specific point of contingence within psychoanalytic theory and practice that could cause the most resistance. This article is an initial step to engage with the resistance encountered in analytic spaces when we shift from a binary system to a non-binary way of thinking gender and sexuality. I will describe the experience in an attempt to provide models of understanding and working through these types of conflicts. Why am I calling it a conflict? This will be better answered with an example, in this case a non-clinical general vignette. I will disguise the participants' identities and will use a composite vignette to protect confidentiality. The Trouble with Ambiguity In 2016, I was delivering a workshop to strengthen clinical skills when working with racialized LGBTQ patients from a psychoanalytic perspective using an anti-oppressive approach. I was surprised to hear a senior analyst openly state from the back of the room that they preferred to hold on to their prejudices regarding trans and gender-creative patients. The audience mostly consisted of psychoanalysts, psychoanalytic candidates, training [End Page 94] analysts, and psychology graduates interested in psychoanalysis. Given the wide range of the audience and our shared interest in psychoanalysis, I usually clarify Freud's "progressive" perspective toward homosexual patients and the distortions of Freud's statements as the message got passed around through generations of culturally sanctioned homophobic clinicians (Socarides 1968; Roughton 2002). The questions from this particular audience led to a discussion about misconceptions in psychoanalytic literature about trans experiences and of trans bodies being misrepresented and misdiagnosed as psychotic (Millot 1989). Addressing misrepresentations of gender variance rooted in prejudiced formulations of trans subjectivities within psychoanalytic theory and proposing less-biased ways of approaching gender polymorphism from a non-pathological perspective can be a complicated task. This is not unheard-of in our field; in fact, queer theorists, Lacanian analysts, and transgender...