Guilt, Shame and Longing

An abortion heavily burdens the woman psychologically and can lead to a subsequent illness, «post-abortion syndrome» (PAS). Triggers sometimes automatically form internal images and associated feelings such as anxiety and panic attacks.

The picture a patient painted describing her feelings shows her in a cage. (Picture: © A. Pokropp-Hippen)
The picture a patient painted describing her feelings shows her in a cage.

Thus a teacher was constantly reminded by the children in her class of the child she aborted, who would have been the same age. After the abortion her self-esteem decreased to the extent that she did not even trust herself to drive a car any longer and ultimately became unable to work. A therapy that did not deal with the trauma of the abortion caused the symptoms to shift: The patient could drive a car again, but now suffered from a fear of cancer. Only psychotherapy which included the abortion and its attendant circumstances made the woman able to process the trauma and live her life again.

The personal joint responsibility for abortion makes overcoming the trauma more difficult. Often the women (and men) cannot forgive themselves when they recognise that they aborted a child. Three factors impair the healing process: guilt, shame and longing for the child.

A couple had been married for a long time when the woman became pregnant. Two consultations «open to any outcome» did not give the woman the reassurance she was looking for about life with a child. The husband wanted a wife who was free of conflict about the pregnancy, and pressed for an abortion. After the procedure she awoke with the feeling of a huge emptiness inside and thought, «I cut my life off». She became severely depressed. Both partners thought about suicide. The marriage went through a tremendous crisis. The man recognised that instead of protecting wife and child, he had acted selfishly. A replacement child was meant to help alleviate the longing for the lost child. The birth was complicated and the baby had to stay in the paediatric clinic for many days. The mother immediately developed fears of loss. These are often an expression of unconscious punishment fantasies. The parents lived with the child in an atmosphere of constant conflict and with the internal imperative to suffer from each other. Life was not supposed to be beautiful any longer because the first child was not allowed to live.

Psychotherapy raised awareness of these connections. The picture shown here a patient painted describing her feelings shows her in a cage. She has no hand and feet, unable to act, without roots. Her mouth is sad. She sees herself in the blood of the child in the cage imprisoned by her shame and guilt. Other women, she says, also suffered this way: «We must finally open these cage doors of concealing and talk about how much a person can suffer after an abortion.»

Dr. med. Angelika Pokropp-Hippen*

* Dr. med. Angelika Pokropp-Hippen is a specialist in general medicine and a psychotherapist with her own practice in Münster, Germany. She has a great deal of experience with patients who suffer from PAS.