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Shapiro, S.H. (1973). Preventive Analysis Following a Trauma—A 4½-Year-Old Girl Witnesses a Stillbirth. Psychoanal. St. Child, 28:249-285.

(1973). Psychoanalytic Study of the Child, 28:249-285

Preventive Analysis Following a Trauma—A 4½-Year-Old Girl Witnesses a Stillbirth

Stanley H. Shapiro, M.D.


An account of the treatment of a 4½-year-old girl has been presented. The goal of therapy was to prevent the traumatic effects of having witnessed a stillbirth at home. The rationale for a prompt brief psychoanalytic treatment prior to the resolution of the child's oedipal phase was discussed. The methodology of such an approach relied upon analytic insights into the developmental process. The necessity for close cooperation and involvement of the mother of the preschool child in the treatment process was amply corroborated.

The technique aimed at fostering verbalization and identification of affects to facilitate ego mastery over the traumatic events. The traumatic episode was reconstructed and connections between masturbation guilt and hospitalization were disrupted. Sexual information was given about the birth process and procreation to help Linda assimilate appropriately what she had seen. Through the dual approach of rectifying distortions demanded by her unconscious (analysis), and supplying appropriate information (education), Linda's ego was strengthened.

The apparent successful outcome, as seen in a 10-year follow-up, encourages the use of such an approach as an example of an abbreviated psychoanalytic therapy suitable for use in preventing the effects of trauma on the developing personality.

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