Slowly light enters my mind and the legend

has vanished like a dream.

The child that clings to the love of his mother

now realizes how silly he’s been.

Deceit awaits him who’s born of a mother:

He’s either deceived or to deceive he’ll try.

If he struggles on, he’ll die of this but if

he gives in, of that he’ll die.

Attila Jozsef: Belated Lament, 1935

(Translated by John Székely)2


Ferenczi (1929) writes about the unwelcome child who is not ushered into this world with care and grows up in the grip of the death instinct, with a depressive streak and a weakness in the capacity for life. Andre Green’s (1986) concept of the dead mother describes a similar phenomenon, by which the image of a loving mother is transformed into an inanimate, dead parent. The absent mother becomes the negative, which will then take up a central position in the child’s psyche. Winnicott (1956) describes a different maternal participation, and proposes that towards the end of her pregnancy the ordinary devoted mother develops a psychological condition which he calls primary maternal preoccupation, the main feature of which is the mother’s heightened attunement to her baby at the expense of all else. I suggest that there is a potent and clinically relevant connection among these concepts: a depressed or damaged mother can still provide temporary devotion before reverting back to a state of depressive absence and that, conversely, even the devoted mother will eventually recover from the state of primary maternal preoccupation and begin to tend to other matters, and the mother’s reclaiming herself can be traumatic for the child even under the best of circumstances. The connection among these concepts is illustrated with clinical material, including transference and countertransference implications, from the treatment of a young woman who grew up as an unwelcome child.

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I wish to thank Adrienne Harris, PhD, Tony Bass, PhD, and the editors of the American Journal of Psychoanalysis, Giselle Galdi, PhD and Endre Koritar, MD, for their invaluable contributions to developing and revising this paper.

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Correspondence to Veronica Csillag.

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Address correspondence to Veronica Csillag, LCSW, 113 University Pl, #1009, New York, NY 10003.

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Csillag, V. FROM PRIMARY MATERNAL PREOCCUPATION TO DEAD MOTHER*. Am J Psychoanal 78, 384–401 (2018).

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  • unwelcome child
  • dead mother
  • primary maternal preoccupation
  • absence and annihilation
  • countertransference