Parental narcissistic injury following child acquired brain injury (ABI): Exploring self-object needs and emotional experience.

Abstract

This article applies Kohut's theory of self-psychology to parent-child relationship following medical trauma and explores the narcissistic injury among parents of children who undergo redevelopmental trajectory as they recover from pediatric acquired brain injury (pABI). Fifty two parents in the pABI group, and 50 in the control group of typically developing children, participated in this cross-sectional study. Parents' experience was assessed using a multiscale Two-Track Bereavement Questionnaire/Two-Track Coping with Life Questionnaire, respectively, and the Self-object Needs Inventory. Parents in the pABI group reported significantly more emotional hardships and difficulties in coping, a tendency to idealize their past relationship with the child, as well as a significantly lower Need for Twinship and Need for Mirroring. Moderation analysis revealed that-among the pABI group-the higher the Need for Idealization, the few parents reported their relationship with the child preinjury as close and positive. Similarly, the higher their Avoidance of Mirroring, the more conflictual the preinjury relationship with the child was reported. The results highlight that pABI involves a loss and rupture in self-object bonds and enhances parental narcissistic injury. To cope with the loss, parents modify self-object needs and their perception of the preinjury parentchild bond toward estrangement. Such modifications may complicate parent-child relationship postinjury, parental emotional adaptation, and should be addressed in psychotherapeutic work with parents.