Spilt Milk

Edited by Joan Raphael-Leff, this short volume gathers lectures given by members of the British Psycho-Analytical Society on the psychic work of early parenthood and on what happens when it collapses. The chapters move from the ordinary developmental upheaval of having a baby and the shifts pregnancy forces in the internal world, through the intrusion of prenatal screening technology into maternal fantasy, to stillbirth, neonatal death, post-partum disturbance and puerperal psychosis.

The clinical argument is that grief and psychic collapse in this period follow their own logic and make specific demands on technique. Raphael-Leff opens with the practical problems of perinatal therapy: how mourning a baby differs from other bereavement, how a pregnancy after loss carries the earlier death inside it, and how acute maternal disturbance pulls on the therapist's own capacity to contain. The volume gives the clinician close accounts of these states and of the countertransference they provoke when a parent is grieving or acutely disturbed.