The Creative Use of Birth Stories in Psychoanalytic Treatments

Abstract

Birth stories, as told to patients by caregivers, represent an important clinical communication to psychoanalysts in case conceptualization and clinical process. Because birth stories illuminate many of the relational themes between the parent’s unconscious experience of creation/caregiving and the child’s experience of entering into a particular caregiver’s world, these stories often foreshadow the self/other configurations that come about in the family of origin and within the self, as well as later in the treatment experience vis a vis the enactive dimension with the analyst. The clinical utility of the birth story will be illustrated in a clinical example in which the emergent properties of therapeutic action are emphasized. The emergent properties of therapeutic action refer to the experiential process, as opposed to its outcomes, from within a contemporary psychoanalytic praxis.

Keywords:

• Birth stories
• enactive dimension
• emergent properties
• therapeutic action

Notes

1 The birth story that gets passed onto the patient can include the story of an adoption, assisted conception or biological conception or any variation therein.

2 Chefetz defines the enactive dimension as: “the repetition of past interactions…based on implicit, procedural knowledge that everyone uses and gathers over a lifetime through behavioral experience” (p. 34).

3 Throughout the paper I use the term “mentalize” to capture the phenomena of grasping both the relevant affective data to a situation but also the symbolic meaning that may be attached to specific mental states of self and other. While traditionally the term is meant to refer to one’s ability to reflect upon one’s own state of mind, and to link intention to mental states, in psychoanalysis the therapist is required to mentalize the patient’s experience in a way that may not have happened well or well enough, in the original dyadic encounter between infant and parent (Fonagy et al., 2002). To this end, I believe the therapist mentalizes unconscious experience as well as conscious content.

4 The clinical case is disguised to protect the identity of the patient and the treatment. Names and other identifying information have been changed.