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The “Motherhood Constellation”

In my article (Toronto, 1999. The Application of Therapists’ Maternal Capacity in Prerepresentational Body-Based Transference and Countertransference. Psychoanal. Soc. W., 6(2):37-59) I describe the manner in which maternal functioning at its best is replicated in the consulting room in work with pre-verbal material.

Daniel Stern has provided intricate descriptions through which we are able to understand the mothering experience, previously thought of as intuitive or even instinctual, in terms of micro-events. These are distinct from macro events that occupy most clinical theories, such as the birth of a sibling, the mother’s emotional availability, and so on. The clinical analysis of micro-events involves questions such as the following: What is the physical distance between the partners? What is the physical orientation -turned toward the side or full-facing? Where are the eyes looking? Is there a mutual gaze? How loud or soft are the vocalizations? It clearly illustrates that it is not just the baby’s reaction to the mother, but also the mother’s reaction to the baby, which creates their relationship.

The Life-Growth Theme

Stern suggests that the mother’s capability to respond to the needs of her infant arises out of a unique psychic organization which he calls the “motherhood constellation” (1995). He identifies several themes that emerge when a woman becomes a mother in our culture. The first, called the life-growth theme, involves the following basic question: Can the mother keep the baby alive? Can she make the baby grow and thrive physically? He adds that this theme is unique in the life cycle and, I would add that it is unique to women There are no other comparable relationships or points in the life cycle where one person is responsible for the life and growth of another.

The Primary-Relatedness Theme

The second, called the primary-relatedness theme, involves the mother’s social-emotional engagement with the baby. Can mother love the baby? Can she feel that the baby loves her? Can she realize that this is truly her baby? Stern states that this concept of primary relatedness concerns the very essence of what it means to be human, including the establishment of basic human ties of attachment, security, and affection.

Again I add that this type of relationship is also unique in the life cycle. The work of early mothering literally transforms a biological organism into a human being. I believe that it is the influence of these two themes which creates the singular quality of the mother/infant relationship. Furthermore, their primal urgency ensures the kind of avoidance and denial which has made it so difficult to explain them in terms of simple human behavior.

Primary Maternal Preoccupation

Winnicott’s concept of “primary maternal preoccupation”(1957) is similar to that of the motherhood constellation, particularly the primary relatedness theme. He states that soon after conception is known to have taken place the woman begins to “shift some of her sense of self on to the baby that is growing within her.”(1965, p. 53) Through projective identification with the baby, the mother is able to achieve a powerful sense of what the baby needs.

Interestingly enough, Winnicott also draws a comparison between the mother and the analyst who is attempting to meet the needs of a patient who is reliving these very early stages in the transference. He states that the analyst goes through changes in his or her orientation which are similar to those of the mother but that “the analyst, unlike the mother, (italics mine) needs to be aware of the sensitivity which develops in him or her in response to the patient’s immaturity and dependence”(1965, p. 53). While he acknowledges that it is important and useful to understand maternal sensitivity, he continues to overlook the subjective state of the mother.

It is my belief that while certain aspects of mothering may alter in intensity during crucial phases, the fact that women can mother and universally have mothered, is a critical organizing factor in their psychic lives. It is a fact which prevails whether they have actually given birth or not. I further believe that women’s reproductive capabilities are a central organizing aspect of their psycho-sexual development. I do not wish to enter at this point the current debate about the constructionist versus essentialist, fluid versus fixed nature of gender. While I feel that it is a useful debate and relevant to this topic, my purpose for this paper is to explore those aspects of mothering that are pertinent in the clinical setting. In doing so, I cannot ignore the obvious fact that it is women who have mothered throughout human history. Furthermore, “new” fathers notwithstanding, the experience for most of us and for most of our patients was that of being cared for as infants by women.


Stern, D. (1985). The Interpersonal World of the Infant. New York: Basic Books. [→]

Stern, D. (1995). The Motherhood Constellation. New York: Basic Books.

Winnicott, D.W. (1965). The maturational process and the facilitating environment. New York: International Universities Press. [→]


The “Motherhood Constellation”

Ellen Toronto, Ph.D.

Dr. Ellen Toronto is a licensed clinical psychologist/psychoanalyst in the state of Michigan.

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APA Reference
Toronto, E. (2020). The “Motherhood Constellation”. Psych Central. Retrieved on November 24, 2020, from


Last updated: 2 Jul 2020
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