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Solnit, A.J. Stark, M.H. (1961). Mourning and the Birth of a Defective Child. Psychoanal. St. Child, 16:523-537.

(1961). Psychoanalytic Study of the Child, 16:523-537

Mourning and the Birth of a Defective Child

Albert J. Solnit, M.D. and Mary H. Stark, M.S.


Our work in psychoanalysis, child development, pediatrics, and social work has reflected a continuing interest in the mutuality of theory and clinical work. The present paper arose from our observations

that the theory of the mourning process was essential in order to understand the depressed reactions of certain mothers to the birth of their children. Although this could be observed most clearly and dramatically when a defective child was born, it was apparent to a lesser degree in the birth of children who were not overtly or significantly abnormal. One mother's depressed mourning reaction occurred when a son was born. In later years she said that it took her three months to resign herself to the loss of a daughter and to accept her son.

Another interest served by this paper is the opportunity for the application of insights from the study of human behavior to the care of the child in a family. The critical application by pediatric colleagues of suggestions and explanations resulting from this study has sharpened the analysts's clinical work and theoretical deductions. Observing and theorizing are reciprocal activities. While the pediatrician can make certain observations that are not available to the analyst, the former needs a general theory of human behavior to help him organize and comprehend his observations. Certain of the theoretical and clinical formulations in psychoanalysis suggest applications in a nonanalytic setting. Often these are guides to be used in child rearing or in the prevention of trauma when a child is physically ill. The pediatrician is in a position to apply many of these insights and to raise questions that stem from his clinical experiences. In a recent symposium on psychosomatic aspects of pediatrics, Anna Freud (1961) said: "I can only say that if I were a pediatrician I would start a fight for the pediatrician's influence from the start."

In our investigation of the grief reaction of mothers who have given birth to defective children, we were able to demonstrate that the physician's awareness of the mourning process enabled him to provide effective therapeutic help to the mother and her child. Additionally, the physician's awareness then extended to the concept that a mother's depressed reaction to the birth of a normal child might reflect her feeling of loss because of a significant discrepancy between her expected or wished-for image of the child and the actual normal child.

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