This paper advances the proposition that in carrying out the decision to undergo elective abortion, a woman experiences a potentially traumatizing psychological event. Vignettes from clinical practice illumine the symptoms and development of post-traumatic stress disorder in the aftermath of abortion. A model of psychic trauma is presented to account for the nature of abortion as a traumatic Stressor. It is based on psychoanalytic considerations, with an emphasis on the role of aggressive energy in the reconfiguring of psychic activities following trauma. The concept of an intrapsychic conflict between the basic drives leads to an understanding of the post-traumatic state, and its persistence.
American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders. (3rd ed., rev.). Washington DC: APA.
Amick-McMullan, A., Kilpatrick, D., Veronen, L., and Smith, S. (1988). Family survivors of homicide victims: Theoretical perspectives and an exploratory study. Journal of Traumatic Stress 2(1), 21-35.
Barnard, C. (1991). Stress reactions in women related to induced abortion. Newsletter, Association for Interdisciplinary Research in Values and Social Change 3(4), 2-3.
Brenner, C. (1986). Discussion. In A. Rothstein (Ed.) The reconstruction of trauma, 195-203. Connecticut: International University Press, Inc.
Dagg, P. (1991). The psychological sequelae of therapeutic abortion-denied and completed. American Journal of Psychiatry 148(5), 578-585.
Emery, P. (1987). The dynamics of PTSD based on ten propositions. PTSD Quarterly Newsletter 4(4), 1-3.
Emery, P. and Emery, O. (1989). Psychoanalytic consideration on PTSD. Journal of Contemporary Psychotherapy 19(1), 39-53.
Erikson, E. (1950). Childhood and society. New York: Norton.
Erikson, R. (1990). Dissociation, aggression, and re-enactment: the structure of psychic trauma. Paper presented at the 7th International Conference on Multiple Personality and Dissociative States. Chicago, Illinois.
Freud, S. (1920). Beyond the pleasure principle. In J. Strachey (Ed.) The standard edition of the complete psychological works of Sigmund Freud, Vol. 18,7-64. London: Hogarth Press.
Janoff-Bulman, R. (1985). The aftermath of victimization: Rebuilding shattered assumptions. In Figley, C. (Ed.) Trauma and its wake. New York: Brenner Mazel.
Kernberg, O. (1984). Severe personality disorders. New Haven: Yale University Press.
Pines, D. (1982). The relevance of early psychic development to pregnancy and abortion. International Journal of Psycho-Analysis 63,311-319.
_____ (1990). Pregnancy, miscarriage and abortion: A psycho-analytic perspective. International Journal of Psycho-Analysis 71, 301-307.
Reardon, David C. (1987). Aborted women: Silent no more. Westchester, IL: Crossway Books.
Selby, T. with Bockman, M. (1990). The mourning after. Grand Rapids: Baker House.
Speckhard, A. (1987). Psycho-social aspects of stress following abortion. Kansas City: Sheed and Ward.
Stanford, S. (1986). Will I cry tomorrow? Healing post-abortion trauma. Old Tappan, N.J.: Fleming Revell.
Stotland, N. (1992). The myth of the abortion trauma syndrome. Journal of the American Medical Association 268(15), 2078-79.
Robert C. Erikson, Ph.D.
Robert Erikson, Ph.D., is a clinical psychologist in Brecksville, Ohio, where he has recently completed four years as Director of the Center for Stress Recovery, the posttraumatic-stress-disorder (PTSD) treatment program at the Cleveland VA Medical Center. He is in private practice and is active in professional and community affairs. He received his doctorate from the University of Arizona in 1976, and has 15 years of clinical experience in the assessment and treatment of PTSD with a variety of populations, including post-abortion women. Correspondence and requests for reprints should be addressed to: Robert C. Erikson, Ph.D., 8748 Brecksville Road, #222, Brecksville OH 44141.
JOURNAL OF PRENATAL AND PERINATAL PSYCHOLOGY AND HEALTH publishes research and clinical articles from the cutting edge of the science of prenatal and perinatal psychology and health. The journal, published quarterly since 1986, is dedicated to the in-depth exploration human reproduction and pregnancy and the mental and emotional development of the unborn and newborn child.