Repeated abortion as a way to process mental pain ¹⁶⁷³

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.

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

Column: Psychoanalytic researches