Abortion is really a controversial subject in any culture from moral, religious, personal beliefs and medical views of what is right, wrong and the rights of women. In this post I will make an effort to show the approach taken from a psychotherapeutic perspective as to how a woman can be assisted in making decisions about her very own well-being, the life span of the developing fetus, the personal and social impact of this decision on her life, her family and her relationships. We will also cover briefly and in context the thought of termination, of having an unplanned miscarriage and sudden infant death including infanticide of children in a further paper to be published.
Introduction
The first evidence of an abortion dates back to an Egyptian Ebers Papyrus in 1550 BC that depicted the methods used for relieving the women of the unborn child. (1) Various accounts ever sold going back more than 100 years discussing abortion whether accepted or not and the penalties of killing an unborn child (often inflicted on the ladies for disobeying her husband in losing her baby) can be seen – this is simply not today’s medical choice but a historical phenomenon showing that abortion was an issue from the beginning as controversial and difficult topic to go over.
In modern days the issue across cultures still rages on with particularly polarised religious and moralistic viewpoints in regards to what is right, what is allowed and what’s seen as wrong (an offence) it really is under this pressure and social umbrella that women have to come to terms with your choice of whether after they discover they’re pregnant how exactly to decide whether they should terminate of not.
Psychotherapy itself makes no judgemental issue as to the rights and wrongs of abortion although individual therapists may have strong religious or moral views of this issue. Where the therapist has a conflict of judgement they should clearly remove themselves from the problem of counselling a woman or couple of an abortion choice and should leave the matter to more professional therapists that stand by their non-judgemental stance in therapeutic situations. Any psychoanalyst who allows his or her personal prejudices in to the therapy room should you should think about a big change of profession or at least declare that their professionalism is tainted by their very own belief system. In saying that one also needs to declare their personal beliefs whether in the pro-life camp or the absolve to decide camp.
In the beginning of a therapy session boundaries and objectivity ought to be set right from the start with the client (patient) letting her or them know the limitations of your service and the difficulty in arriving at a any decision that feels emotionally completely right. In my practice I set the boundary of who makes your choice to abort of not. I ensure it is abundantly clear that the ultimate say is in the hands of the pregnant woman only. That her partner, medical advisers, counsellors, members of the family are just secondary considerations to her own well-being and decision. This sense of responsibility is vital in the emotional recovery of deciding to just do it having an abortion. Later she cannot turn to other people as forcing her, influencing her or elsewhere persuading her to just do it when she was not sure. She must accept it is her decision and her final responsibility to just do it or not. The reason that is important is that after the event she must be emotionally clear that she made the very best decision for herself.
The Therapeutic Process
In the initial session it is advisable to establish the term of the pregnancy so far. (2) This gives afterward you a timetable for the decision process. Different countries and cultures have different times limits for when an abortion is still possible medically. Around the globe this can change from eight to twelve weeks with variations from country to country. Therefore if the obstetrician has determined she is 6 weeks pregnant in a twelve week system you have at least five weeks to decide (although a decision to have the abortion should be made as quickly as possible as procedures change on how the abortion is completed medically). Once this timetable is established it has two effects, one determines the number of sessions the therapeutic process can be bought out, and two a certain pressure on the woman to come to an early resolution in what she wants to do.
Once this is established the woman seeking counselling about an abortion ought to be encouraged to speak her mind about her fears, doubts and concerns about seeking an abortion to begin with. Once she’s vented her view (which maybe quite confused at this stage) it is possible to reflect back to her what she stated where her feelings and reasons for the abortion. It’s also advisable to establish why she is having doubts about the abortion, such as for example guilt, personal beliefs, practical considerations, fear of loss, inability to get a child later on (real or not), the effect on her personal relationships with partner, husband, friends and family. It is always beneficial to have a whiteboard in a therapy office as this assists to list and clarify for the woman a visual cues to her dilemma. Later is can also act as a benefits and drawbacks list on her behalf to again give clarity her known reasons for an against having the abortion. This first session if very practical in setting the scene for further psychoanalytical discussions. In addition, it helps the therapist to get insight into the main issues the client maybe dealing with psychologically. By the end of the hour this can be a good idea to give a homework assignment to be emailed back again to the therapist before the next session. Usually it is a one page biography of her life with the initial paragraph dealing with her very own parents, family and upbringing, the next her developing years and any significant events and finally a short paragraph on the here and today situation. The reason of one page only is that it helps the client to target only on the important issues. This biography can then be analysed by linguistic analysis and reflected back the customers at the second session. Why is it important to discuss her background and upbringing? From the psychoanalyst perspective her history can tell us a whole lot about her mental conflict over her decision for an abortion today. For example an extremely religious upbringing, poor parenting, abuse in childhood, sibling relationships, previous personal relationships, prior abortions or sexual history. Any of these areas could be impacting on her behalf current inability to see clearly what her own choices should be in the moment.
Abortion in Istanbul Turkey
In the next session it is best to ask your client what her thoughts had been about the clarification process of the initial session, then if time, go through and reflect from her biography what issues arose when she wrote it, what thoughts had she about her past influencing the existing situation? Also the therapist can reflect what they saw in the biography that struck them as significant and have for the customers clarification and reflections. All of this is to enable your client through psychoanalysis to have insight into their own character shaped by past events and help with a clearer knowledge of the reasons for her emotional considerations in her decision making process now. By now an obvious idea should emerge about her main thoughts and position of her decision to get an abortion. She may not have made up her mind completely yet but is certainly getting a better idea of the choice that faces her.