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Ward, A. (2001). ‘Spilt Milk’: Perinatal Loss and Breakdown. Edited by Joan Raphael-Left. London: Institute of Psycho-Analysis. Pp. 100. £8.99.. Psychoanal. Psychother., 15(2):196-201.

(2001). Psychoanalytic Psychotherapy, 15(2):196-201

‘Spilt Milk’: Perinatal Loss and Breakdown. Edited by Joan Raphael-Left. London: Institute of Psycho-Analysis. Pp. 100. £8.99.

Review by:
Anne Ward

This is one of a series of low-cost books bringing together the best of a now-extant series of Public Lectures hosted by the British Psycho-Analytical Society. The editor describes its ‘extremely lengthy gestation;, beginning with an idea proposed by her in 1987, and eventually encompassing presentations from 1985 through to 1993. The contributors are all psychoanalysts, but with varying perspectives on perinatal disturbance. The ‘spilt milk’ of the title refers to actual perinatal loss, as well as to loss of an idealised baby to the realities of birth and early motherhood. There is something of this raw quality in the book itself: because it is a collection of actual presentations, rather than a commissioned series of chapters, it can seem both inspiring and frustratingly incomplete. I wanted more from some of the contributors, notably Bourne & Lewis, who write rather briefly about actual perinatal loss; and I would also like to have heard from other authorities in the field, eg Alicia Etchegoyen, without whom such a volume seems incomplete. However, this is the real baby, and worth engaging with. (In parentheses, it has taken me an inordinately long time to produce this review; so I have some sympathy with the editor.)

Joan Raphael-Leff is well placed to act as midwife to such a project, having seen 150 childbearing individuals or couples in this group, over a career spanning twenty-five years. She sets the scene in a comprehensive introduction, describing the peculiar nature of psychoanalytic work with pregnant women and young mothers. There is something about this period which renders primitive phantasies more accessible, and thereby (she contends) more available for psychoanalytic intervention. Whilst acknowledging her years of experience, I have a reservation about this as a general comment (picked up later in the book by Bourne & Lewis), which is that this very turbulence can cause some young women to take flight.

A pregnant patient told me that coming through the doors of our Hospital ‘stirred up all that bad-mother stuff — not that I think I am a bad mother, of course’. She did not engage in therapy (not entirely due to bad technique on my part, I hope).

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