Observations on the Post Abortion Syndrome

1. Observations on the Post Abortion Syndrome DOES IT REALLY EXIST?

2. Yes it does! • In spite of opinions that are published to the contrary. There is scientific evidence to document the validity of the diagnosis! • Published reports in refereed journals provide us wit the validity of the harmful effects of abortion. They are: • physical and • psychological

3. Physical Harm • 10% of all abortions have unintended complications. They are: • Infection occurs in 27% of the patients • 3to 5% of all women become sterile and are more likely to have ectopic pregnancies • Cervical lacerations occur in 22% of eh women that later result in early deliveries or in miscarriages • Finally there is a 30% increased incidence of breast cancer in women who have first pregnancy abortions

4. Psychological Harm • There is only one positive emotional response to abortion and it is relief. • Relief from the embarrassment of having an unwanted child if the are single and • Relief from the potential duty of rearing an unwanted child

5. Psychological Harm • Even if there are positive effects 40 to 60% have negative emotional responses. These are: • 55% have unremitting guilt • 31% have regrets • 33% have sleep disturbances • 10% have serious psychiatric problems immediately afterwards

6. Psychological Harm • The greatest psychiatric harm occurs in women under 17 years of age. • Interestingly there is in many a period of denial of 5 to 7 years that is used to prevent negative feelings from rising in consciousness.

7. Psychological Harm • 25% of all women who had an abortion eventually saw a psychiatrist for disturbing symptoms, vs 3% of women who delivered normally. • Among a large group of patients • 46% had feelings of self hatred • 49% used drugs and • 39% either began to use alcohol or increased their use

8. Psychological harm • 60% reported suicidal ideas • 28% attempted suicide. 50% repeated the attempt • There is an incidence of completed suicide that is 6 times greater in women after abortion compared with those who delivered normally.

9. Psychological harm • What about men? • It is reported that 75% of men who accompany their consorts to have an abortion have psychiatric sequelae. • It is also true that siblings who know their mother had an abortion are also affected negatively. This affects their feelings of wantedness

10. Etiologic • Abortion can give rise to major depression serving as a precipitating factor • It can give rise to an existential depression that mimics major depression or dysthymic disorder • It can cause a person to abuse drugs and alcohol • It can be etiologic in Anorexia Nervosa or bulimorexia

11. Case Illustrations • I have seen over 300 women who have had illnesses that were caused by abortions or to which abortion was a major contributor • I will present three of these

12. Cases • Case 1. This woman was a 43 year old wife of a physician who had been ill for three years. Her main complaint was an intractable depression that had not responded to treatment. Many medications had been tried and she only got partial relief. She was self referred to me for a second opinion.

13. Case 1 • When my efforts at treatment using different meds and cognitive behavioral therapy did not result in relief I decided to review her history. There were three major factors that seemed to be contributory. They were: • 1. She had been rejected as a Bible study leader and her faith had been questioned

14. Case 1 • 2. She was under great pressure a mother and church leader • 3 she had been in an auto accident with her son, but neither had been injured. Her car was totaled, though, when she rolled it. • She detailed her history of thse factors, but it was not until she told me of the accident that I learned something new.

15. Case 1 • She told me that she was taking her dyslexic son for treatment in a nearby city when she detailed how she rolled her Volkswagen. • After she told me of the accident I asked her what she thought as the car rolled over.

16. Case 1 • She said, “Now I will have killed both my sons!” • “But you have only one son,” I said. • “ Oh! I didn’t tell you. I had an abortion. I knew he was going to be a boy, and I was going to name him Christopher.”

17. Case 1 • With this knowledge we used a spiritual intervention called “Requiem Healing.” During the intervention she had profound emotional release and in one week was symptom free. Her meds were DC’d and she has remained well for over 28 years.

18. Case 2. • She was a 30+ year old woman who presented with intractable suicidal ruminations She had been hospitalized 5 times before for suicidal intent. I did all I could to relieve her depression using all the interventions I had available, and finally had to discharge her only slightly improved. Some months after she went home she committed suicide

19. Case 3 • She was the unmarried daughter of a high official in the Malagasy Lutheran Church. It is illustrative of a 20 year old woman who lived in Madagascar. • I was in the country teaching primary care physicians basic psychiatric diagnosis and treatment. • I was asked to see her because she was displaying psychotic symptoms that had not responded to treatment by 1 of the countries 6 psychiatrists.

20. Treatment • I noted in case 1 that we used a intervention called “Requiem Healing” • This was used in the other two cases as well with equally good results. • What is it?

21. Treatment Theory • Etiologically I have to say that one has to understand what happens when a woman becomes aware of her pregnancy. The child instantly becomes a part of her psychospiritually. The process was called by Bowlby (1982) “attachment”

22. Treatment Theory • However, Julian Marias in his book Metaphysical Anthropology called it “installation.” The latter word indicates that it is in internal event. He points out that all relationships involve installation. Those of a person with a spouse, a child, a friend and God.

23. Treatment Theory • We were all created with a radical need for relationships • With a mate • With children • With friends • With God

24. Treatment Theory • Installation is complete and instantaneous in pregnancy • And in conversion with God • It is a process but becomes complete in time in the installation of a mate • And is gradual, but partial with a friend

25. Treatment Theory • When we install any of these people we live our lives for them. • Wherever we go they go too • The same is true for the person with whom we have a relationship

26. Treatment theory • The installation is a supernatural phenomenon • The installation is extremely strong and can be ended only with great mental work or by death • The mental work necessary for ending it is called grief

27. Treatment • If indeed the fetus is installed completely in the woman it is clear that she must grieve to end her relationship with the person Francke called the “Little ghost within.” • Since she is not allowed to grieve either by providers or her mate she has unresolved grief. It gives rise to the emotional symptoms we described earlier

28. Treatment • In the 1980’s Sack described the consequences of spontaneous abortions • 1. Others do not know the woman is pregnant • 2. The woman is embarrassed to tell people she has lost a baby • 3. She has not usually identified the baby as a person

29. Treatment • 4. She is not able to identify the baby as someone else • 5.She rarely sees the baby she a has lost • 6. There is no funeral so they can only fantasize about its sex, size and personality

30. Treatment • 7. There is rarely recognition by the caregiver that a significant event has occurred • 8. No one encourages her to grieve • 9. There is no anticipatory grieving

31. Treatment • Several authors have commented on the need to resolve the grief, but few have offered any methodology to bring about the resolution • There is a 1944 study by Lindemann that does offer help

32. Treatment • Lindemann has best described the role of religion in the process of grief resolution in his observations on the psychiatric aftermath of the Coconut Grove fire.

33. Treatment • Fisher has utilized his work in a program for the resolution for grief in widows. • Kenneth McAll did the same for abortion

34. Treatment • I fist learned of this method in 1978 when I met Dr. McAll • He had observed that many women he treated who had abortions would be healed if a memorial service similar to the Catholic Requiem Mass would be performed

35. Treatment • He collected an enormous number of cases beginning in 1950 of women who were healed using the technique of “Requiem Healing.” • Among these in time were 441 cases of anorexia nervosa

36. Treatment • Since I was seeing more an more women who had abortions and were had developed disabling symptoms after the procedure I used his techniques with results similar to those he got.

37. Treatment • If I ascertain that the woman had an abortion or miscarriage as a determinant of her illness • I ascertain her level of spirituality • This is done by taking a spiritual history • If I think she is sufficiently spiritually sophisticated I ask if she had any notions as to the sex of the child an what she would have named him/her.

38. Treatment • I then get her to describe her feelings at the time of the abortion and afterward • I then try to help her understand the future she has with the child • This future is base on a hopeful biblical understanding of the afterlife.

39. Treatment • We then conduct a service that is a modified service used by Methodists for the communion service • One can use the service for the dead in the book of common prayer

40. Treatment • This is modified to include in the prayer of confession the admission that the woman took the life of the child and is truly sorry for doing so • After the confession they commit the child to the Lord while visualizing their doing so

41. Treatment • In the visualizing of the release of the child, they see themselves standing at the threshold of God’s kingdom • In the background is the light of god’s presence • The patient then visualizes angels coming to the threshold and the mother passes the baby to the angels who carry it off into the light of God’s presence

42. Treatment • The mother tells the child good-bye. We end by repeating the Lord’s prayer • If possible the Eucharist is celebrated at this time • The latter is not necessary for resolution of their grief

43. Comments • There has been at times enormous resistance to integrating faith with the practice of medicine or psychiatry • Even so over 80 medical schools have courses in spirituality and medicine

44. Comments • There has though been steady progress in bringing about his integration • Psychiatry has however not shown much interest, but instead had turned to using medications to treat everything

45. Comments • Managed health care has precipitated this change • So we now neglect the psychological and spiritual aspects of our patients problems and end up treating major mental illnesses

46. Comments • Residency training provides little instruction in anything besides the biological aspects of our patients illness • To handle these problems the patient is referred to counselors and psychologists who are ill prepared to treat them

47. Comments • Why? • They like most psychiatrists • Deny the supernatural, • have a limited worldview, • are not taught about the nature of man, • do not understand that man is a spiritual being, • and do not know how to use spiritual interventions,

48. William P. Wilson MD • Professor Emeritus of Psychiatry • Duke University Medical Center • Distinguished Professor of Counseling • Carolina Evangelical Divinity School • www.InstChristiangrowth.org • wpwilson@netpath.net