CARING FOR THE POORLY MOTIVATED (CONCLUSION)

Apr 7, 2009

Mrs H.’s unpredictable behaviour resulted from her conflict between the wish for a stable life and motherhood and the desire for a good time. She had no model of a stable mother hence her distress and anger when her first social worker left. Hurt and rejected by her mother, she nevertheless envied her apparent freedom and gaiety. She loved her father but also despised him for being unable to control her mother. These feelings were later transferred to her husband. Without inner control she looked to others for control, but then found difficulty in accepting it. Her very inadequacy as a mother made her get pregnant in the hope that she could prove she was different from her mother. However, each time she found the demands of babies and small children too great.

In this case a measure of understanding about the unconscious forces underlying Mrs H.’s actions, and close co-operation between the doctor and social worker, allowed a consistent approach, and prevented the conflict about control being acted out between those who were trying to help.

Sustained support from the same workers over a considerable time is needed for such women until they can take the responsibility for contraception themselves. It is essential for the woman to be supported in her choice of method so that she can learn about her own limitations in using it. Eventually she may come to accept that outside control – in the form of sterilization – is the answer, but this can be done only when the woman herself wants it and should never be imposed.

*32/197/1*