The Devouring Mother
The devouring mother is a psychological archetype of a narcissistic, authoritarian and controlling mother, who can become psychologically suffocating for her children.
Archetypes and the collective unconscious
Carl Youg (1875-1961)
Clara's clinical report
(Fictional narrative)*
Clara, a physician and professor of a recognized school of medicine, used to express authoritarian, dominant and rigid behavior. She recently faced a divorce, but kept the children, who were raised under an overprotective dome and became infantilized. Unfortunately, they were not prepared for adulthood and reacted with the expected emotional immaturity when facing maternal illness. Despite being well informed, Clara expressed denial. History shows how the doctor must understand family dynamics and respect patient's defense mechanisms.
Abstract
Overview of the emotional flow and decisive moments in the care of a narcissistic lady, who remained in denial, just to disguise her controlling maternal behavior, which led her to a distorted view of the illness. Respecting Clara's attitude, the doctor had to find an inventive strategy to communicate with the patient. Here you will find the segmentation of the plot, describing how the doctor dealt with the challenges presented by Clara's clinical case: The exposition (PLOT 1) took place at the doctor’s office. Surprisingly, it was Clara’s children who came for the first consultation. Despite not having consent, they had looked at their mother's exams and found that she had an ovarian tumor. The rising action (PLOT 2) occurred when Clara agreed to attend the first consultation, just to satisfy the children's appeal. She was not comfortable and expressed denial. The conflict (PLOT 3) occurred after the physical examination, when the doctor explained the findings and the need for surgical intervention. The doctor did not try to modify the denial behavior expressed by Clara, which was responsible for the turning point. Clara was feeling safe and confident and the climax (PLOT 4) was marked by a tacit acceptance of the treatment. In the falling action (PLOT 5) Clara faced her treatment with no major complications and had a chance to reorganized the family dynamics.The resolution (PLOT 6) will be presented by the storyteller in a comprehensive biopsychosocial approach.
Emotional Flow
The graph presented below is a simplified depiction of Clara's emotional flow. At each PLOT element the patient-physician relationship leads to emotions that occur along distinct time intervals (△t). The interventions are responsible for the emotional flow, which is unique to each story. The continuous sinuous blue wave represents the oscillating patient’s emotional status, with the larger inflection representing the “turning point”.
Author's perception of the patient's emotional flow and turning points
*James Fleck, MD, PhD is a full professor of medicine at UFRGS, Brazil
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Those plots are an objective way to categorize some scenario that usually happens. It seems to be so, to help new physicians to deal with that kind of situation and also to help them to lead, if possible, the conversation. Despite that, it is important to mention that each case is unique, although they vary into the same categorization. With this in mind, the physician must understands the patient's feelings and respect them, let the patient feel the struggle, and resolve them alone, only with the help of his doctor. It does part of the hole 6 plots process.
A negação é um dos mecanismos de defesa mais comumente usadas em situações difíceis para o paciente e o ser humano em si, entender e respeitar o que o paciente está vivenciando é extremamente importante para que ele possa passar pelo processo de aceitação da doença, compreender as dinâmicas familiares também podem ser aliados na aliança terapêutica e no almejado sucesso clínico.
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