McClatchey, Jo (2013) Am I the only one? What happens in a parent support group in a Neonatal Intensive Care Unit (NICU)? Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust.

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Abstract

The focus of this research is a small piece of clinical work, which was undertaken in a hospital setting over a number of years. It describes what happened in a drop in group offering support to parents in a Neonatal Intensive Care Unit (NICU). The parents who came to the group all had babies who were in the NICU either because they were born premature or were very sick. The group was co-run by a nurse from the unit and a child psychotherapist. The research methodology used a combination of group process notes and interviews and employed the Grounded Theory Method, combined with psychoanalytic theory, to identify some central unconscious phantasies and to look at some of the unconscious group processes in operation. Four major themes were identified and explored in detail. These were:Trauma and the fear of annihilation; this dimension explored the impact that trauma and catastrophic dread can have on parents, and the defences they develop to cope. It then looked at the impact of these defences on the groups as a whole. The second dimension, A safe place to let off steam? Destructive feelings, focused on the powerful fantasy of ‘a safe space’, and fears about ‘letting off steam’ and it also explored some of the ways ‘unbearable states’ were communicated. The third dimension, was called Consent, paternal function and the growth of skin. This dimension incorporated ideas about the growth of skin, and a corresponding emergence of important boundaries between internal and external reality, and alongside this, the development of a paternal function. The fourth and final dimension was called ‘Am I the only one?’ Reaching out and Reclamation. This dimension gathered together ideas related to a question asked repeatedly by parents, and it explored how new connections emerged and the factors that aided resilience. This dimension explored ideas about the phantasy of creating a new couple, and how this creative and potent connection both internally and externally can aid parents in reclaiming their baby for their own. I looked at the role the group played in enabling this to happen. Through these dimensions the research explored why a group could be supportive for parents, and looked in depth at one way of providing support to help parents cope with trauma and separation at the beginning of life. Taking the psychoanalytic ideas of containment and maternal reverie it looked at how the group itself provided a variety of different types of containment for the parents who attended. Three different types of group container were identified: first, a ‘flexible container’ which allows mutual adaptation and growth, second a ‘rigid container’, which 3 provides a kind of blank stonewalling defensiveness in which contents are crushed, finally a ‘fractured or fragmented container’, when the contents overwhelm and destroy the container. The research identified examples of different types of group containment and the impact the wider groups around the babies as well as the institutional structures have on these early attempts to become a parent. The conclusions explore the importance of this type of support for parents and babies, both at a micro level, where the group could be seen as enabling parents to find their own perspective and their own level of participation. Also of consideration is the importance of the group for the unit as a whole. Reflecting on recent reports into NHS failures of care, the research highlights the importance of providing a supportive space for thinking about emotionally painful experiences, for everyone working and caring for these babies, whether they choose to attend it or not.

Item Type:	Thesis (Professional Doctorate)
Additional Information:	A thesis submitted in partial fulfilment of the requirements of the University of East London in collaboration with the Tavistock and Portman NHS Foundation Trust for the Professional Doctorate in Psychoanalytic Psychotherapy with Children, Adolescents and their Families
Uncontrolled Keywords:	Professional Doctorate in Psychoanalytic Psychotherapy with Children, Adolescents and their Families, University of East London
Subjects:	Children, Young People and Developmental Pyschology > Babies Families > Childbirth Psychological Therapies, Psychiatry, Counselling > Family Therapies
Department/People:	Children, Young Adult and Family Services Research
URI:	https://repository.tavistockandportman.ac.uk/id/eprint/2964

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