Fathers and Perinatal Loss Pt. 2: Literature Review

Tracy Schaperow, Psy.D.

Tracy Schaperow

Licensed Clinical Psychologist

This article is part of a larger work.

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Chapter II Literature Review

Expectant Fatherhood

The intent of this section of the literature review is to illustrate three points: (a) the desire to be a father stems from early in life, (b) fatherhood has been considered a developmental phase that promotes growth, (c) and fathers may feel vulnerable during the transition to parenthood.

The Development of Paternal Identity.

Several theorists believe that the wish for a child among men is complex desire that is deeply rooted from early in life (Diamond, 1995; Ross, 1975; Tyson & Tyson, 1990). Tyson and Tyson (1990) maintain that the wish for boys to bear children is particularly prominent during their anal stage of development (ages one to three). Boys are primarily exposed to their mothers during this phase, resulting in the identification with and imitation of her through assisting in household tasks and engaging in fantasies of bearing a child. Simultaneously, boys experience anal and genital sensations during their anal phase, which accentuates fantasies of giving birth to a child.

Michael Diamond (1995) speculated that boys have their earliest wish for a baby during their oral and anal psychosexual phases of development. He believed that during those phases, boys fantasize about the oral incorporation and the anal rebirth of their mothers. For instance, a boy might fantasize about eating his mother s breasts (oral incorporation) and later restoring her through his anus (anal rebirth). Gradually, while still in their preoedipal phases, their fantasies include both parents, and they imagine their fathers impregnating their mothers; often by defecating or urinating on them. Eventually, boys focus primarily on their fathers. For example, the boy might wish to incorporate his father s penis and restore him as a baby boy so that he can reverse the father-son relationship.

Similarly, Ross (1975) reported that young boys, in the preoedipal phases, identify with and desire to be like their mother by giving birth to a baby. However, once the phallic stage (ages three to five) of development begins, most boys shift their main identifications to their father and begin to fantasize about getting an infant from their mothers, rather than wishing to be like their mothers and growing a baby inside of themselves. Ross also believed that the wish for children stems from boys desires to overcome their feelings of rage and helplessness toward their mothers because of her authority and omnipotence. By wishing for children, boys are competing with and attempting to achieve power over their mothers.

It has been reported that later in development, boys begin to give up their wish of giving birth to a baby. In his review of Freud s ideas, Michael Diamond (1995) reported that once reaching their Oedipal phase of development, boys discover the female genitalia and believe that girls have lost their penises. This discovery leads boys to fear that they themselves will be castrated, thus prompting their decision to further identify with their fathers, because they believe that their fathers have not been castrated. As boys develop these masculine identifications, they begin to fantasize about impregnating their mothers, and they relinquish or repress their wish to grow babies inside of themselves.

In conclusion, some theorists believe that the wish for a child among men is deeply rooted from early in life. Although these ideas appear to be widely accepted among theorists, they are primarily based upon clinical cases, and no systematic quantitative evidence exists to support them.

Parenthood as a Developmental Phase.

Some theorists believe that parenthood can be conceptualized as a developmental phase or task in adulthood (Colarusso, 1990; Leon, 1990; Parens, 1975). Therese Benedek was the first person to term parenthood a developmental phase, as she did so in her presentation to the American Psychoanalytic Association in 1958. She speculated that during each “critical period” in their child’s development, parents re-experience their own childhood phases, thus having the opportunity to rework them, and achieve a new level of intrapsychic organization (Parens, 1975).

In an annual meeting of the American Psychoanalytic Association in 1974, a panel debated the question of whether biological parenthood was a developmental phase (Parens, 1975). During the conference, Kestenberg, for example, suggested that parenthood is a phase of adult development because it entails anxiety, conflicts, and defense mechanisms that lead to a change in psychic structure in each subphase. In contrast, panel member Sylvia Brody argued that biological parenthood is not necessarily a developmental phase because the biological aspects of becoming a parent, such as pregnancy and nursing, have a psychological impact that lasts sometimes for just a short time. Brody suggested that those biological parents who do not have the ability to rear a child may not undergo the structural changes in their ego and superego that characterizes a new developmental phase. Therefore, each parent’s ability to rear a child must be considered before calling parenthood a developmental stage. Similar to Brody s view, William Thomas Moore suggested that, unlike most developmental phases, biological parenthood does not necessarily involve structural changes in the superego and the ego. He believed that any of the changes in the ego and superego that do occur are the recycling or rejuvenation of earlier conflicts and defenses, not the structural change of developmental issues. Although this panel of speakers did not agree on whether parenthood is a developmental phase, the chairman, Irwin Marcus, concluded that parenthood evokes anxiety and conflict, which may or may not induce personality growth.

Other theorists do not label parenthood a “developmental phase,” but believe parenthood can fulfill some adult developmental tasks. Erik Erikson suggested that parenthood could fulfill an adult phase of development (Davison & Neale, 1996; Erikson, 1964). In his eight-stage model of the psychosocial stages of development, he proposed that the seventh stage, Generativity versus Stagnation, was a major phase of adulthood. Generativity refers to the production, creation, and caring for the next generation. It is achieved by giving to the next generation through having children, working, or engaging in creative endeavors, and represents the successful resolution of this phase of development. Conversely, stagnation is the lack of productive endeavors, and can lead to boredom and a lack of a sense of caring. Therefore, someone who has not had children and has not found a way to give to the next generation in another way may suffer through stagnation. Erikson speculated that the successful resolution of earlier psychosocial stages helps to facilitate the resolution of later stages. For example, in Erikson s first stage, trust versus mistrust, the infant learns (or does not learn) about consistency, predictability, and reliability in the caregiver s behavior. However, without experiencing consistent care giving as an infant, an individual may struggle to give to the next generation as a parent in the generativity phase of development. Consequently, this individual may have difficulty successfully achieving generativity (Davison & Neale, 1996).

Expanding upon Margaret Mahler s theory of the separation-individuation process, Colarusso (1990), conceptualized biological parenthood as the beginning of what he called the third individuation. He defined the third individuation as a, "continuous process of elaboration of the self and differentiation from objects which occurs in the developmental phase of early (20 to 40 years) and middle (40 to 60 years) adulthood" (Colarusso, 1990, p. 181). He believes that this individuation involves separating from one's own parents and creating a family by procreation. Because the new or expectant parent often feel guilty for separating, they have a child as a "gift" for their parents (Colarusso, 1990; Diamond, 1986).

The third individuation is facilitated by producing a situation in which infantile themes and relationships can be reworked in relation to phase-specific, adult, developmental tasks and conflicts" (Colarusso, 1990, p. 184). In other words, each phase of the child’s development produces a different “situation” that challenges parents to further develop. For instance, at the time of pregnancy and birth, the parents’ sexual identity is enhanced because they realize that their sexual apparatus can perform their primary functions. When their child is in their preoedipal phases, the parents work through their early relationships with their own mothers as they reverse roles and become the all-powerful omnipotent caretakers. During the oedipal phase, the parents rework fantasies and impulses through interacting with their spouse, parents, and children. In the latency phase, the parents must relinquish control of their child’s bodily functions, thoughts, time, and relationships; and therefore, mourn the loss of the pleasure obtained from being in control over a dependent child. When the child becomes an adolescent, the parents work through the separation, and accept their child’s preparation for replacing them as the most significant person in life.

Psychological Experiences of Expectant Fathers.

There is some speculation that men regress and rework their object relations during their wives pregnancies (Bortz, 1994; Leon, 1990; Osofsky, 1982; Zayas, 1987). Osofsky (1982) believes that expectant fathers, when they first learn of their wives pregnancies, experience excitement, pride, and relief about their virility. However, these feelings are soon followed by experiences of stress and upheaval, which stem from regressive pulls, unresolved conflicts, and earlier life experiences.

In his doctoral dissertation, Bortz (1994) attempted to demonstrate empirically that men, in their transition to fatherhood, regress and rework object relations. Using the Early Memories Test, the Blacky Picture Test, and the MAACL-R, the study found that husbands with pregnant wives did not regress and rework object relations any more than husbands whose wives were not pregnant. However, husbands who had wives who were in their first pregnancy spent more time thinking about their relationship with their fathers than did the other husbands. Bortz (1994) noted that his recruitment strategy might have led to a self-selection bias in his study, in favor of healthier, less-regressed men. In other words, the men who were psychologically healthy were willing to participate in the study and were not as prone to demonstrable regression and the reworking of object relations during their wives pregnancies. Conversely, men who were not psychologically healthy and who were experiencing more distress, possibly due to regression induced by the pregnancy, did not volunteer for the study because they were undergoing an abundance of turmoil: regressing and reworking their object relations. D. J. Diamond (personal communication, April 3, 2000) also suggested that any regression occurring for men might be delayed until after the actual arrival of the baby, whereas for women, with the physical stimulus of the pregnancy itself, regress may occur earlier.

Pregnancy and new fatherhood are also believed to trigger unresolved Oedipal issues (Jarvis, 1962; Zayas, 1987). Generally, the successful resolution of the Oedipus Complex is known to occur when the child relinquishes the desire for the parent of the opposite sex, identifies with the parent of the same sex, and seeks a partner of the opposite sex outside the family (Zayas, 1987, p. 15). However, in many males, the Oedipus Complex is not fully resolved in childhood, and is triggered again during expectant fatherhood. Thus, during his wife s pregnancy, the expectant father may struggle to identify with his own father, while trying to remain close to his wife, who represents his mother (Zayas, 1987).

In a case study of an expectant father, Jarvis (1962) illustrated one man s struggle to resolve his Oedipal Complex. He described a man who engaged in behaviors during his wife s pregnancy that were uncharacteristic of him. In the beginning of her pregnancy, he was jealous of her social activities, had tantrums when she upset him, and could not stand to be separated from her. Later into the pregnancy, the father labeled his wife as physically sick, and took care of her. He did all of the cooking and cleaning in the house. Furthermore, he fantasized about giving birth to a baby, and decided to leave his career to become a food caterer.

This case illustrates several Oedipal issues that were triggered for this man during his wife s pregnancy. When his wife was first pregnant, he remembered how he could not possess his mother, even though he was attracted to her, because she chose his father. As a result, he became angry with his wife, who represented his mother. To retreat from his anxiety about being angry at her, he identified with his mother by cleaning the house, fantasizing about having a baby, and desiring a more nurturing career as a food caterer (Jarvis, 1962).

It has been postulated that dependency needs are also intensified during expectant fatherhood (Zayas, 1987). Often, a man who has a strong attachment to his own parents during childhood, transfers these attachments to his wife. When his wife becomes pregnant, she becomes more involved with herself and the developing fetus, and provides less physical and emotional attention to him. As a result, the man feels unloved and abandoned. He feels ashamed of his feelings of abandonment and dependency. These unfulfilled needs trigger anxious feelings of separation related to past experiences with his mother as a young boy, causing great discomfort.

Some theorists have speculated that issues surrounding childhood sibling rivalry are activated in the male during his wife s pregnancy (Gurwitt, 1976; Zayas, 1987). Pregnancy can cause stress and upheaval in the expectant father, so he may desire to be emotionally closer to his wife than usual. Simultaneously, he may fear losing his wife s attention to the baby. As a result, the expectant father may feel rivalrious and hostile toward the fetus, triggering earlier conflicts of sibling rivalry. These issues may derive from unresolved Oedipal conflicts, whereby the jealousy is displaced from the parent to the sibling/baby, or from earlier preoedipal themes related to dependency and fear of loss.

It has also been postulated that pregnancy causes the expectant father to feel a sense of omnipotence and power (Diamond, 1995; Leon, 1990). Feelings of omnipotence, which begin in pregnancy and further develop as children grow older, serve to deny his aging and ultimate death. A narcissistic injury is also associated with aging and death; therefore having a child may counter this injury by enhancing a man’s self- esteem (Diamond, 1995; Leon, 1990). In writing about the need for omnipotence through having children, Leon (1990) stated:

If facing one's inevitable end is the ultimate narcissistic blow (for what could be more humbling to a sense of personal power and efficacy), pregnancy may normally serve as a vital narcissistic defense, preserving a sense of self-worth and permanence. (p. 15)

The experience of pregnancy for expectant fathers can be greatly influenced by the medical condition of both his wife and fetus. High-risk pregnancies often lead fathers to feeling frightened and out of control because there are so many "unknowns" associated with the pregnancy. These “unknowns” include the mortality of his wife and baby as well as concerns regarding the possibility of taking care of a sick baby (May, 1995). Therefore, fear and anxiety may be heightened for fathers who are dealing with high-risk pregnancies.

Physical Changes in Expectant Fathers.

Many expectant fathers undergo physical changes during their wives pregnancies. Some men engage in dietary and behavioral restrictions mimicking their wife, which is called “ritual couvade” (May & Perrin, 1985). Others develop physical symptoms characteristic of pregnancy, known as “couvade syndrome” (May & Perrin, 1985; Shapiro, 1985). Couvade syndrome is characterized by gastrointestinal disturbances, colds, and aches and pains (Conner & Denson, 1990). It was first discovered by anthropologists who found that in many preindustrial countries, males were engaging in dietary and behavioral restrictions mimicking their wives during pregnancy (May & Perrin, 1985).

Various hypotheses exist regarding the etiology of these syndromes. Couvade syndrome and ritual couvade have been explained as: (a) the man’s attempt to be "more connected" to the pregnancy (Shapiro, 1995); (b) as a way to identify with his wife (Conner & Denson, 1990); (c) as a way to empathize with her (May & Perrin, 1985); (d) a reflection of his envy of his wife's ability to bear children, (e) as representing feelings of anxiety, anger, and ambivalence about the pregnancy (Conner & Denson, 1990); and

(f) as a way to take away the wife's pain in her pregnancy (May & Perrin, 1985).

In sum, becoming a father is a complex process, stemming from early in development. Transitioning to this phase of life, however, can promote growth and further psychological development.

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