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Clinical Perspectives<br><br>Treatment for perinatal disturbance<SUP>a</SUP>
Abstract
The perinatal period of transition to parenthood is one of heightened
passions, which revive the expectant and new parents' own early experiences,
and particularly unresolved emotional issues. For many deprived parents close
contact with an infant reactivates old grievances at this time of vulnerability,
which may manifest in syndromes of self-pity or in fury and vengefulness
over past humiliations. Unprocessed dissatisfactions tend to erupt in disruptive
or repetitious behaviours, which inevitably affect the baby in their care.
In addition, childbearing in societies undergoing transition,
like South Africa, may be fraught with extra stresses. These include socio-economic
disadvantages and social adversity arising from geographical relocation and
breakdown of traditional patterns, and psychological distress due to past
or current experiences of physical or emotional trauma and neglect and relationship
difficulties which tend to be exacerbated in times of rapid cultural change
in the absence of a wider supportive network.
It is argued that, in societies with scarce resources, the mental
health focus must be on prevention, detection of high-risk groups and early
intervention. Two tables are presented — of risk indicators and treatment
guidelines, which may be applied during the perinatal period to minimise
postnatal disturbance. Health workers with minimal training can be effective
in screening and in some cases, delivering prophylactic or postnatal
care to people at potential risk. Offering such help may enable resilient
people in a state of crisis or transition to marshal their own resources.
For others longer-term professional help may be required to shift the chronic
effects of cumulative trauma by reworking emotional predicaments in a caring
and safe environment.
Journal of Child and
Adolescent Mental Health 2003, 15(1): 49-53
passions, which revive the expectant and new parents' own early experiences,
and particularly unresolved emotional issues. For many deprived parents close
contact with an infant reactivates old grievances at this time of vulnerability,
which may manifest in syndromes of self-pity or in fury and vengefulness
over past humiliations. Unprocessed dissatisfactions tend to erupt in disruptive
or repetitious behaviours, which inevitably affect the baby in their care.
In addition, childbearing in societies undergoing transition,
like South Africa, may be fraught with extra stresses. These include socio-economic
disadvantages and social adversity arising from geographical relocation and
breakdown of traditional patterns, and psychological distress due to past
or current experiences of physical or emotional trauma and neglect and relationship
difficulties which tend to be exacerbated in times of rapid cultural change
in the absence of a wider supportive network.
It is argued that, in societies with scarce resources, the mental
health focus must be on prevention, detection of high-risk groups and early
intervention. Two tables are presented — of risk indicators and treatment
guidelines, which may be applied during the perinatal period to minimise
postnatal disturbance. Health workers with minimal training can be effective
in screening and in some cases, delivering prophylactic or postnatal
care to people at potential risk. Offering such help may enable resilient
people in a state of crisis or transition to marshal their own resources.
For others longer-term professional help may be required to shift the chronic
effects of cumulative trauma by reworking emotional predicaments in a caring
and safe environment.
Journal of Child and
Adolescent Mental Health 2003, 15(1): 49-53
