IPA web site's Debate, “New Families: What Psychoanalysis has to say about them”

IPA web site's Debate, “New Families: What Psychoanalysis has to say about them”

by Mali Mann, MD, Chair of North American Committee of Child and Adolescent Psychoanalysis ( NA-COCAP).


Our new world creates an acceptance for variety of people to make a baby. People with genetic problems, same gender couples, donor eggs, donor sperms, embryo donors and surrogates who carries the fetus are all involved in a particular form of procreation. These individuals participate in making of a new family, which is different from traditional patterns of family making styles. This new form of extended family complex raises questions about our psychoanalytic understanding of pre-oedipal mother and Oedipal complex, and attachment patterns to the primary care givers. People involved in assisted reproductive technology possibly claim their share of parenthood and entitlement to the child. This new phenomenon affects the siblings’ dynamics as well as the over all larger family matrix. Does it mean the new family structure is in need of “do overs” in life? What are the culturally acceptable ways of relating to each family member and how do various roles get negotiated?

The child coming out of this new family structure is also in need of help to identify the primary care giver in order to feel safe and ideally form a secure attachment. What is communicated to the child about his or her origin and what is kept in secret for reasons related to parental unresolved psychological conflicts, also potentially impact their developmental trajectory.

These different family dynamics are rather new and their members enter into uncharted territory. They cannot rely on the inherited historical generational wisdom or experience. The parents conceivably have to rely more on the expertise of mental health professionals for guidance, since the older generation of grandparents are at loss, not knowing how to negotiate their roles in such newly made and defined families. The earlier psychoanalysts, Freud, Melanie Klein and Ana Freud’s work were focused on Oedipal conflict and constellation. However, it is worth mentioning the contemporary developmental analyst Diane Ehrenstaft’ s work. In her book of 2008, “Mommies, Daddies, Donors, Surrogates Answering Tough Questions and Building Strong Families”, she criticized the orthodox psychoanalytic concept of the Oedipal stage and alerted the clinicians to expand its scope to include the importance of psychological theories of psychosocial and psychosexual development to accommodate to the realities of modern day families.

We have to face the new reality of today’s modern phenomenon. We live in a world in which the assisted reproductive technology (egg and sperm donors, donor insemination, surrogate mothering or any combination of these) is being used more prevalently these days than two decades ago. ART helps infertile people; and as a result, the non-traditional families are increasing.

There are ethical dilemmas as to how to acknowledge and respect the rights of biological parents as well as the right of psychological parents. Issues of secrecy and hiding the facts about the biological mother also create its own sets of unpredictable developmental problems in the lives of these children.

Additionally, We need to think about how our ideas about developmental perspectives might need to be modified, adjusted or changed. In our role as clinicians we should be mindful of the impact of assisted reproductive technology and its’ serious influence in the lives of individuals involved and their off spring.

From a psychological perspective, some men and women experience their resort to assisted reproductive technology as a failure—a failure of masculinity or femininity with respective gender. The use of such procedures could also cause unpredictable traumatic experience, which is bound to influence the family.

On a more existential level, infertility and the use of assisted reproductive technology affects individuals’ sense of who they are and who they imagine they would become as new parents and a family. The fundamental value—a capacity for creation—has been so deeply rooted in a sense of bodily self that individual belief systems about one’s identity become challenged.

Patients struggle consciously and unconsciously with the meaning of borrowing eggs or sperm from other people. Earlier unconscious conflicts reappear and affect their sense of identity and their relationship as a couple. Intense emotions erupt without knowing how to mange them while undergoing repeated reproductive procedures, and even several years later as parents of the child.

We as analysts and psychotherapists can offer a safe holding environment in which to explore thoughts and emotions and phantasies of our patients around the formation of their newly formed and defined families

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