The choice of the specialist in gynecology / obstetrics is a personal decision of the woman that can be determined by infinity of situations and variables. It is a feminine affair that necessarily implies the relationship of the woman with her body and her femininity, which is associated with the primary maternal bond.

In this paper I will try to portray the dynamics of the encounter between the patient and the specialist doctor in this area, through the various evolutionary facets and from the archetypal perspective.

Laura Morandini. Clinical psychologist. Psychotherapist

morandinil@cantv.net

When a young girl has been mother-oriented in the changes of her body and the implications of menstruation, she probably takes the consultation with some naturalness – within the normal anxiety that this situation of invasion of intimacy can generate. If there has been no guidance in this regard and the information has been collected a little here, a little with the friend and another little in a magazine, it is likely that the anxiety is greater and the expectations generate great apprehension. However it will not be only the previous experience which will determine the attitude towards the query, but also the characteristics of personality.

The young women are generally taken by their mothers to the gynecological consultation at the time of development, or a little earlier, however when adolescents begin to experience sexuality, the presence of the mother in a matter so private could become a situation uncomfortable The doctor at this vital stage may perceive himself as a patient’s confidant and counselor, but in some cases as an accomplice to the mother, so the presence of a third party in consultation can be experienced as a persecutory experience. But this is not always the case, in fact the young women who live symbiotically with the mother (where sexuality is inhibited and there is no room to develop one’s own individuality) require – and hope – the maternal presence to feel protected, in a situation which can sometimes be fantasized even as a “violation”. In other cases, when there is not enough trust with the mother, the young women come with a friend who can support a situation that generates fear and shame, being able to feel deeply alone or on the contrary very free. The difference will always be determined by the personality characteristics of each person or by what in deep psychology is known as archetypes.

It is not the same, for example, the relation that maintains with his body a woman who embodies the archetype of Aphrodite that a Demeter, Artemisa or Athena.

Let us dwell briefly on each of these “ways of perceiving the world.”

The Aphrodite woman, regardless of her body – whether fat, skinny, tall or short – will feel comfortable with him, tend to beautify and care for him. You will live your sexuality to the fullest and the subject of motherhood is probably not your favorite. The approach to the gynecological consultation can revolve around the concerns regarding pregnancy and methods to prevent it. Promiscuity may be a risk factor in relation to the transmission of venereal diseases, since in these women the passion over reason predominates. It will tend to pick a male specialist.

Artemisa maintains a virginal relationship with her body, will not be very friendly to doctors and any pain or discomfort will prefer to wait for the body to resume its state of balance before deciding to make a medical appointment. Feel that treatments and explorations are an invasion of your body. She firmly believes in the wisdom and natural balance of the organism and is likely to explore with natural medicine, only when forced to undergo treatment will tend to choose female specialists. For her the man is perceived as a stranger and invader of his intimate world that he holds with so much suspicion. He considers that a woman is an accomplice by nature and that only by living similar experiences is she able to understand it.

Athena, the rational woman, cerebral and organized, with his great intellectual development lives separated from his body, considering it a utilitarian part of which he remembers when he becomes ill. Preferably choose a male doctor, who is the best or the most renowned, someone whom she cherishes for his professional development. It is probable that he arrives at the consultation with a diagnostic hypothesis already studied, entering into competition with the specialist and consequently questioning the treatments. They are difficult, hard and intelligent women. The consultation proves to be one more procedure, a way to prevent and control the maladjustments of the body and to preserve health. Many women dedicated to medicine respond to this archetype.

Kore (girl in ancient Greek) is the maiden, the woman-girl, timid and passive, fearful. She perceives her childish body without being aware of her sexual or sensual attributes, has not integrated the image of the woman into her psyche so she may perceive unnecessary gynecological checkups or treatments. It is the woman who shakes before consulting, feels attacked and vulnerable (I think that in all women at some point this archetype has been awakened by a gynecological consultation) where the doctor can be perceived – in analogy with the myth – as the raptor who initiates the young towards a new vital experience. These patients are those who do not know to go alone for consultation, and usually go with the mother who usually calm their anguish. The mother is more than likely to choose a female specialist not to expose her child in the “claws” of the male.

In this way we see that there are personal differences that may determine the choice of the doctor, and although the patients expose the reasons apparently more crazy and irrational, we know that the final choice will not be a product of chance but of the “archetypal footprint”:

“If he’s going to touch me, let him be a man!” (Aphrodite)

“A woman understands better” (Artemisa)

“What does a man know about the body of a woman if he has never had the rule!” (Artemis)

“I prefer a man because I feel protected” (Demeter)

“To me they take me and turn off the light, I close my eyes and wait for him to do his work” (Kore)

“It’s enough for me to be an excellent professional, but I do not know why a man gives me more confidence” (Athena)

Many women will be able to argue that they did not choose the doctor but of small they simply “took” them; so it happened and so they assumed. This could be an argument and example of maternal identification (“As my mother chooses a female / male gynecologist, I do so). This is not a problem, on the contrary, it is always good to have a trusted specialist in the family. The problem exists when the woman still does not feel comfortable with the gender of her doctor follows it by habit, routine or by family / social commitment.

There is a vital moment in which the woman takes the consultation with the gynecologist very differently and it is during the period of the pregnancy. At this stage the Demeter archetype is usually activated so that for her to be pregnant requires attentions very different from those that can be given normally in a gynecological consultation. A good doctor practices this change slowly and knows from experience when he must stop being perceived by his patient as a gynecologist to become an obstetrician. This arrangement generates an atmosphere of confidence and emotional tranquility in the future mother during the following months of gestation. The woman when entering the consultation would like to stay there being spoiled and informed about the smallest detail about each of the changes that await her. This, as long as it is a pregnancy of healthy and normal evolution. We find two individuals who represent deeply different characters in key lifetimes: woman and gynecologist, mother and obstetrician.

During pregnancy, “something” changes internally in the woman’s psyche and the physician’s attitude would be expected to be geared towards sensitivity and versatility in order to respond to the antagonistic needs present in each of her patients. The pregnant woman has such varied demands, concerns, fears and expectations-not always evident-that it may be difficult for the treating physician to intuit and respond to these changes. Maternity certainly transforms the woman, puts her in a state of greater receptivity and sensitivity so she can feel subjectively mistreated if she does not feel understood by who will be a fundamental figure in the coming months: nothing more and nothing less who will take charge to bring your child to light.

It is important to clarify that there are women in whom the maternal instinct never wakes up and prefer a technical obstetrician (usually the Athena women). His interest is centered in knowing the formal aspects of the consultation and the disconnection with his state prevails. This type of patient is not ideal for an obstetrician connected with his vocation, but it is a reality among many others.

The sensitivity of the patient is always discussed and the sensitivity of the obstetrician is obviated. There is no comment about the pregnant woman affectively isolated from her condition; however the technicality and the coldness of the doctors are criticized, but if they are sensitive then give a false image of weakness or fragility.

They do not make it easy either!

If we remember the story of the centaur Kiron, the archetype of the healer-wounded, we know that his healing function was intimately related to his own wound, that is to say with his physical and psychic pain. Here underlies the principle that to be able to cure others there is before having experienced pain. It is through sensitivity that arises from the pain from which arises the therapeutic space and the attitude towards healing.

Where is the point of balance between sensitivity and technique?

Why, where one seems excellent, one specialist disappoints, and vice versa?

Each person will find their answer based on their experiences. I think life is very broad and we must leave room for its various manifestations. Depending on the internal needs that we are experiencing in a moment, these will give rise to interesting meetings or sometimes to bitter disagreements. This is valid in the context of all human relations where the attitude that is assumed before the reality of the other, can be the key to establishing relationships of quality.