Making Sense of Pre-Symbolic Trauma: A Qualitative Study on the Lived Experiences of Adults Who Were Born Extremely Prematurely
The psychological experiences of adults (n=5) who were born at or before the threshold for extreme prematurity (weeks) was examined using Interpretive Phenomenological Analysis (IPA) (Smith, Flowers & Larkin, 2009). Subjects were interviewed to learn about how their extreme prematurity has become organized and integrated on the levels of fantasy, identity and personality. Results showed that dysregulation and the propensity to self-contain on both somatic and affective levels were common themes across cases, supporting current research connecting the ongoing impacts of prematurity to the context of overstimulation and fundamental absence in the first months of life in the NICU. Despite demographic variance among participants, certain self-representations and corresponding affect links commonly emerged across cases, providing insight into internalized objects representations and relationships held by participants, as well as familial attitudes about subjects and their prematurity specifically. The interviews reflected a process of mentalization, differentiation, ambivalence and mourning around the significance of extreme prematurity in participant’s lives. Participants were able to generate novel preterm self-representations indicating the evolution of a personal preterm narrative as distinct from previously foreclosed birth narratives determined by family trauma responses. Gradual identification with parents over the course of the interviews appeared to signal one of several entry points for increased fantasy activity around a preterm self-representation. Results suggested that a simple interview broaching this topic can help mobilize psychic trauma and facilitated participants in moving from a blocked engagement with their birth story (and unsymbolized but registered aspects of the preterm experience) to one that generates curiosity, imagination and dream-thought.
Clinical Psychology, Preterm birth, Extreme prematurity, Presymbolic trauma, NICU experiences, Maternal trauma, Preterm narrative
City University of New York - Graduate Center
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The Graduate School and University Center of The City University of New York