i
Duke University
Medical Center
Intercom
VOL. 25, NO. 25
JUNE 23, 1978
DURHAM, N.C.
Fatherhood no picnic either, psychiatrists say
By David Williamson
(Editor's Note: David Williamson, medical
writer in the Office of Public Relations, expects to
become a father for the first time in November,
While experiencing some insomnia, he has not gone
through the other "sympathy symptoms" of
pregnancy he writes about here. His wife Sandy
would unselfishly have shared some with him.)
Just about everyone knows that
pregnant women can experience a
number of unpleasant symptoms during
the nine months before they give birth.
Among these side effects of impending
motherhood are "morning sickness,"
headaches, loss of appetite, cramps and
backache.
Not so well known, however, is that
husbands sometimes experience the same
symptoms during the months before they
become fathers, according to Drs. Jesse
O. Cavenar Jr. and Nancy T. Butts,
psychiatrists who have studied and
written about the phenomenon.
Cavenar is an associate professor of
psychiatry here and chief of psychiatry at
the VA Hospital. Butts, who completed a
residency in psychiatry here last year,
now maintains a private practice in
Chapel Hill.
More common
than generally recognized
In a pre-Father's Day interview, the
two said they believe that physical
reactions in men to ' their wives'
pregnancies or even desire for pregnancy
are much more common than is generally
recognized.
The causes, they said, may be as varied
as the symptoms and range from mild
fears about finances and being a good
father to deep-seated personality
conflicts going back to the husband's own
childhood.
"I think it's important for men to realize
that some emotional upheaval around the
time of pregnancy is to be expected,"
Butts said. "But instead of pushing these
thoughts and feelings under the rug, they
should discuss them with their wives."
In most cases, talks between spouses
will be enough to dispel a man's anxieties
about becoming a father, she said. More
extreme cases may call for psychotherapy
that can last just a few sessions or many
years, requiring hospitalization.
Fatherhood stress
When pregnancy-like symptoms arise
in expectant fathers, and no physical
cause can be found, Cavenar said
psychiatrists call the condition the
Couvade syndrome.
The disorder derives its name, he said,
from the French word meaning "to
brood" or "hatch." Anthropologists in the
last century used that word to describe a
ritual still practiced by certain primitive
tribes in South America and Africa.
"Essentially, the ritual consists of the
husband of the pregnant woman retiring
to his bed during his wife's labor,
simulating or experiencing labor pains,
and receiving attention that would
ordinarily be given to a woman," he said.
"The wife may be lucky if she has one
attendant because almost everyone is
clustered around the husband," Cavenar
said. "There are several different theories
about why this has been done, but I think
it at least shows their appreciation of how
stressful becoming a father can be."
Not so humorous
While the Couvade syndrome usually
disappears around the time of delivery,
occasionally it does not. Anyone who
thinks a husband's fears are humorous
would change his mind if he knew the
heartache those fears can bring into a
marriage.
In a scientific paper they wrote last
year, the two psychiatrists were the first
to point out that unresolved rivalries with
younger brothers or sisters may be a
major factor when the syndrome worsens
after delivery.
In the cases they described, four men
were incapacitated to varying degrees
after their wives announced pregnancies.
Three of the men recovered after they
came to understand that their difficulties
resulted from subconsciously associating
their unborn infants with younger
/Continued on page 41
Pioneer in vitreous surgery
named ophthalmology chairman
One of the world's most highly
respected eye surgeons has accepted an
appointment as chairman of the
Department of Ophthalmology here.
Dr. Robert Machemer, currently
f
WHAT ARE THESE PEOPLE DOING?—This activity, taking place behind
the hospital, may look a little strange, but there's a perfectly logical
explanation of what is going on and why. You can find out by turning to
page 4. In the meantime, here's a clue; June is National Recreation and
Parks Month.
associate professor of ophthalmology at
the University of Miami's Bascom Palmer
Eye Institute, will succeed Dr. Joseph A.
C. Wadsworth in the position Sept. 1.
Wadsworth, who founded the Duke
Eye Center, will continue his practice and
teaching responsibilities at Duke. In
March he turned 65, the mandatory age
at which department heads give up
administrative duties.
Developed revolutionary
new instrument
Almost eight years ago, Machemer and
his colleague Jean-Marie Parel began
developing a revolutionary new
instrument they named the VISC
(vitreous-infusion-suction-cutter). Their
device allowed eye surgeons for the first
time to remove and replace the vitreous
— a normally transparent liquid that
helps the eyeball maintain its spherical
shape — when that liquid clouds up and
blocks vision.
Since then^ vitreous surgery has
developed into an ophthalmic specialty
that provides treatments for many eye
diseases previously considered
untreatable. Among these are the late
stage of diabetic retinopathy, one of the
possible complications of diabetes and a
leading cause of blindness.
Through his subsequent scientific
writings, instructional films and lectures,
Machemer has taught hundreds of other
eye specialists in this country and abroad
to perform the operation safely. He is also
known for his research that established a
good experimental model for retinal
detachment, a vision-threatening
condition that sometimes results from
injury or severe nearsightedness.
Native of Germany
Author of more than 120 papers and a
textbook on vitreous surgery, Machemer,
(Continued an page 3)