Atenção materna primária e consulta terapêutica: uma proposta de prevenção comunitária / Primary Maternal Assistance and Therapeutic Consultations: a community and preventive proposal

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

The state of primary maternal concern is a necessary condition for the baby nurturing motherhood. In this condition, the future mother employs her own experience of having been a baby who was attended by her mother. This research is situated within the project "Fatherhood: therapeutic consultations to pregnant women, developed in the Community of Paraisopolis, in partnership with the Einstein Hospital Program for the Community of Paraisopolis, São Paulo city, Brazil. The general objective of this research was understand the efficacy of therapeutic consultations, created and developed by Donald Winnicott and later expanded by Serge Lebovici, in favoring the state of primary concern in high-risk pregnancy women. The specific objectives were: (a) To prevent somatic and psychological disorders in the development of a secured attachment between mother and her child; (b) To show, throughout a contrasted methodological counter-example, that installation of psychopathological symptoms in early children can be prevented with early mothering intervention. A sample of four emblematic cases of high-risk pregnant women was selected among a population of 120 pregnant women, attended in the period of January 2006 to March 2007. Emblematic cases represent the population on age distribution, high-risk pregnancy, early diagnosis, and questions discussed in therapeutic consultations, case management, and number of sessions. Analysis of clinical sessions and therapeutic consultations showed an increased compromising between mother and baby, resulting of deepening knowledge of their alterity, confirmed after birth by a good enough nurturing mother. It was also observed significant improvement in self, and the presence of hope feelings, which were absent in the first therapeutic consultations. Four factors decisively contributed to good results: the punctuality of the sessions; the clinical power of therapeutic consultation; a natural psychological condition during pregnancy, the training with theory, supervision, and ethical and clinical training, as part of the Fatherhood Project and, finally, the supporting network by the team of Program for Psychological Attention of Pregnant Women. Therapeutic consultations would seem to be a suitable tool for psycho-prophylactic job, especially with mothers with high-risk vulnerabilities.

ASSUNTO(S)

infantis psicoterapia psychoanalysis pregnancy mothers gravidez bebês mães psicanálise psychotherapy

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