Repeated abortion as a way to process mental pain



The focus of the paper is the problem of psychodynamics of the repeated (multiple) abortion phenomena among Russian female patients. Psychotherapists as well as doctors who specialize in female health emphasize high prevalence of the paradox ical pattern of reproductive behavior among Russian women. For some inexplica ble reason it is quite often that women in Russia choose for abortions (including surgical curettage) instead of preventing undesirable pregnancy by usage of contraception. Nevertheless the theme of psychodynamics related to abortions and especially of repeated abortion quite rarely becomes the focus for psychoanalytic writings. This is true not only for Russian psychoanalysts, but also for psychoanalysts from Western countries with well-established psychoanalytical tradition. We hypothesize that the presence of multiple abortions in a grown-up woman's medical history on condition that she has had an access to relatively safe contraceptives for reasonable price (or even for free) suggests that she resorts to abortion as substitute for psychical processing of mental pain and extreme anxiety. We consider the phenomena of repeated abortion from the angles of different theoretical psychoanalytical approaches such as theory of sadomasochistic system of self-regulation by K. Novic and J. Novic, idea of "narcotic solution" by J. McDougal, E. Welldon's conception of female perversion, and others. Limited by the demands to the volume of the publication we bring short consideration of influence on dynamics of multiple abortions of such extremely important factors as psychic trauma and transgen-erational transition of traumatic experience. In the paper we presented a vignette in which we included the story of a patient who underwent repeated abortions and has sought psychotherapy with a female psychoanalytical therapist. In the vignette we demonstrate the influence of family trauma of loss occurring before the birth of the patient on the development of her individuality and the influence of this traumatic event on her choice to have repeated abortions as the only way to solve the problem of undesirable pregnancy.

General Information

Keywords: Abortion, repeated (multiple) abortion, reproductive behavior, psycho-dynamics, psychoanalysis, psychic trauma, mental pain, identity

Journal rubric: Essay

Article type: scientific article

For citation: Agarkov V.A., Bronfman S.A. Repeated abortion as a way to process mental pain. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2014. Vol. 22, no. 2, pp. 191–212. (In Russ., аbstr. in Engl.)


  1. Аgarkov V.A. Bazovye principy psychoterapii posledstvii psychicheskoi travmy. Narushenija reguljatzii vozbujdenija. // Voprosy psychologii extremalnyh situatcii. 2010.  1. S. 11—16
  2. Аgarkov V.A. Bazovye principy psychoterapii posledstvii psychicheskoi travmy. Pamjat posle psychotravmirujyschego perejivanija. // Voprosy psychologii extremalnyh situatcii. 2010.  3. S. 7—15
  3. Agarkov V.A., Bronfman S.A., Orjekhovskaya A.I. Izychenie osobennostei frustratzionnykh reaktzii I mechanizmov psihicheskoi zaschity y litz, perejivshih psihicheskyyu travmy // Voprosy psychologii extremalnyh situatcii. 2009. 4. S. 17—37
  4. Agarkov V.A., Bronfman S.A.,, Kydaeva, L.M., Uvarova E.V. Psihologicheskie aspekty patigeneza fynktzionalnoi amenorei // Psihicheskoe zdorovie 2012. T. 10.  7. S. 70—79 Balint M. Bazisnyi defect / per. s angl. M.: Cogito-Centre 2002. 256 s. Guntrip G. Shizoidnye yavlenia, objectnye otnosheniya I samost / per. s angl. M.: Institut Obschegymanitarnukh Issledoavanii. 2010. 672 с.
  5. Kogan. I. Vtoraya kozha // Psihologiya I psychopatologiya kozhi: texty / per. s angl. Sost. I naychn. red S.F. Syrotkin, M.L. Melnikova. Izhevsk: ERGO; M.: Cogito-Centre 2011. 384 s.
  6. Kochetkov Ya.A. K problem psihicheskikh narushenii posle aborta // Problemy reproduktzii. 2009. T. 15.  2. S. 24—29 McDougall J. Tysjachelikii Eros. / per. s angl. SPb.: Sovmestnoye izdanie VEIP i B&K. 1999. 278 s. Maljychenko I.Ju. Psihologicheskaya pomostch pri postabortnom syndrome I perinatalnyh poteriakh. // Perinatalnaya psichologija I psicjologija poditelstva. 2008. 2. S. 84—92
  7. Padzinskyi V.E. Akusherskaja agressija. / M.: Izd-vo jurnala Status Praesens, 2011,. 688 s. Freud S. Vvedenie v psihoanaliz. Lektzii. / per. s nem. M.: OOO "Firma STD", 2003,. 623 s.
  8. Schmidt-Hellerau C. Vlechenie k jizni i vlechenie k smerti. Libido i Leta. Svodnaja formalno-logicheskaja model psihoanaliticheskoi teorii vlechenii i strukturnoi teorii. / per. s nem. SPb.: B&K. 2003, 298 s.
  9. Adelman A. Traumatic Memory and the Intergenerational Transmission of Holocaust Narratives. Psychoanalytic Study of the Child. 1995. V. 50. P. 343—367
  10. Benedek T. Parenthood as a developmental phase. Journal of American Psychoanalytic Association. 1959. 7: 389—417
  11. Blum H. On identification and its vicissitudes. International Journal of Psycho-Analysis. 1986. 67: 267—276
  12. Calef V. The unconscious fantasy of infanticide manifested in resistance Journal of American Psychoanalytic Association. 1968 16: 697—710
  13. Clarkin J.F, Fonagy P., Gabbard G.O. (Eds.) 2010 Psychodynamic Psychotherapy for Personality Disorders: A Clinical Handbook.. Washington, London, American Psychiatric Publishing, Inc.
  14. Deutch H. 1944 The Psychology of Women, Vol. 1.. New York: Grune & Straton
  15. Etchegoyen R.H. 1999 Fundamentals of Psychoanalytic Technique.. London: Karnaс Books
  16. Fairbairn W.D. 1952 Psychoanalytic Studies of the Personality.. London: Tavistock Publications Limited
  17. Fischer N. Multiple induced abortions: A psychoanalytic case study. Journal of American Psychoanalytic Association. 1974 22: 394—407
  18. Grubrich-Simitis I. Extreme Traumatization as Cumulative Trauma-Psychoanalytic Investigations of the Effects of Concentration Camp Experiences on Survivors and their Children. Psychoanalytic Study of the Child. 1981. 36: 415—450
  19. Joseph B. A Clinical Contribution to the Analysis of a Perversion. International Journal of Psycho-Analysis. 1971. 52: 441—449
  20. Novick J., Novick K.K. Two Systems of Self-Regulation. Psychoanalytic Social Work. 2001. 8: 95—122
  21. Novick J., Novick K.K. The Superego and the Two-System Model. Psychoanalytic Inquiry. 2004. 24: 232—256
  22. Novick K.K., Novick J. Two Systems Of Self-Regulation And The Differential Application Of Psychoanalytic Technique. American Journal of Psychoanalysis. 2003. 63: 1—20
  23. Pines D. The Relevance of Early Psychic Development to Pregnancy and Abortion. International Journal of Psycho-Analysis. 1982. 63: 311—319
  24. Pines D. Pregnancy, Miscarriage and Abortion. A Psychoanalytic Perspective International Journal of Psycho-Analysis. 1990. 71: 301—307
  25. Remeikis G.V. A Review of the Psychoanalytic Literature on Abortion. Journal of American Academy of Psychoanalysis and Dynamic Psychiatry. 2001. 29: 231—244
  26. Stein Y. Some Reflections on the Inner Space and its Contents. Psychoanalytic Study of the Child. 1988. 43: 291—304
  27. Waelder R. Psychoanalysis, Scientific Method, and Philosophy. Journal of American Psychoanalytic Association. 1962. 10: 617—637
  28. Welldon D. 1988/2004. Mother, Madonna, Whore: The Idealization and Denegration of Motherhood.. London: Karnaс Books
  29. Winnicott D. Transitional Objects and Transitional Phenomena A Study of the First Not Me Possession International Journal of Psycho-Analysis. 1953. 34: 89—97
  30. Winnicott D. 1971. Playing and Reality.. London: Tavistock Publications

Information About the Authors

Vsevolod A. Agarkov, Research Associate, Institute of Psychology, Russian Academy of Sciences, Institute of Psychology, Russian Academy of Sciences, Moscow, Russia, e-mail:

S. A. Bronfman



Total: 3985
Previous month: 26
Current month: 26


Total: 2012
Previous month: 9
Current month: 18