The APPA Method - an innovative approach to pregnancy support - strengthening the prenatal bond - an efficient instrument of prevention and salutogenesis 

I would to give you a concrete example that clearly shows in which way the APPA method is an effective means to promote prenatal bonding and attachment which is highly beneficial for the mother and her baby. I summarize in short the development Annette went through during the 6 months I accompanied her with the APPA method.


Annette, a 23-year old student, finds herself in a very precarious predicament. She is pregnant which she considers to be a great misfortune. Her child's father is also a student and their relationship has been relatively short-lived. she does not consider him to be a partner capable of offering her a harmonious and lasting relationship. When she informed him of her pregnancy, he reacted violently accusing her of wanting to trick him into a mariage. His reaction and accusation hurt her a lot which gave her enough stenght to end the relationship immediately.Having been brought up in a very Catholic family, an abortion is no option for her although she did ponder about it for a while. She is deeply troubled because she is sure that her mother considers her pregnancy as an act of failure. Annette seems to be very afraid of her mother and she does not have any hope that her mother will support her in any way.

A friend had told her about the APPA method and without much hope of finding help in my consultation, since she absolutely does not want this child, she makes an appointment with me. I find her very depressed when she first comes to see me.When I ask Annette to imagine the baby in her womb, she bursts into tears and confesses that she feels a strong sense of disgust. She is disgusted by this foreign body that has forced itself upon her without having been invited. Áll she feels is total rejection towards her baby which means that the situation not only dramatic for the young woman, but also and perhaps even more so for her baby. Annette finds herself in a dilemma. She neither wants to keep the child nor have an abortion.

Annette comes to see me once a week, same day, same hour. The regularity of the sessions is important because it conveys to the baby a strong sense of security and reliability. During one of these sessions, Annette tells me that she has never understood why her mother has always blatantly favoured her younger brother. Her mother had very often expressed her disappointment having given birth to a girl. It looks like she has transferred her contempt for womanhood to her daughter, because Annette does not feel good about herself as a woman.

Before starting the sessions the pregnant woman fills out a questionnaire in which she describes in detail her relationship with her mother, her father and her child's father. This decription reveals information about her bonding capacity, her bonding quality and the intenseness of her emotional dependancy on either her mother or father.

What are the real – unconscious - causes of her rejecting her baby?We talk at length about what it means to be a woman. And I ask her, "Since you do not have a very positive image of femininity, and since the womb is the most prominent feature of femininity, is it possible that your rejection of pregnancy derives from the fact that you have somehow internalized your mother's attitude?" Annette starts reflecting about my suggestion.

One week later she tells me that she went home to her parents to inform them of her pregnancy. Her mother assails her with abusive reproaches and furiously demands that she should immeditely have her baby adopted right after birth. For the first time, Annette really feels her mother's rejection consciously ant it fills her with such a strong rage she had never felt before.

During the next session we discuss what "motherly behaviour" signifies. Annette soon realises that she has never received from her mother what she had needed, especially the esteem and appreciation of her femininity, of her own value as a daughter.I ask another question: "Could you imagine to give yourself this appreciation? This might allow you to detach yourself from your mother's negative attitude and allow you to have your own thoughts and opinions. Think about it. What is your potential as a woman? I give her an assignment for the next session: "Go on a journey of self-discovery as a woman!"

Annette arrives at the next session in tears. "I'm expecting a girl, I have just found out. What a horror! How can I love a girl, I who have been so much rejected precisely because I am a girl! I reply, "It's up to you not to repeat your mother's mistakes, you are free in what you think and do." She calms down and smiles at me.

Earlier, Annette had told me about an aunt she liked and spent a lot of time with during her early childhood. She felt loved by this aunt and I ask her to describe in which way her aunt expressed her affection towards her. Annette immediately understands that her aunt's behaviour towards her can serve as a role model for what a „good mother.“ should be like.

One part of the weekly one hour sessions is to lead the pregnant woman in a very deep state of relaxation. While she is in that state I give her special instructions. In Annette's case I ask her to imagine a situation where she treats her daughter in the same way her aunt has always treated her, with gentleness and love. And for the first time Annette manages to imagine on her inner screen her womb opening up to give her access to her baby. Annette is both amazed and astonished! In addition, she feels a pleasant warmth insie her belly !

During the following sessions, the contact between Annette and her baby intensifies and the emotional bond becomes stronger and deeper. Annette is now very proud to be carrying a child and goes shopping for the baby with her aunt. She chooses a beautiful name for her daughter with great tenderness and love. Finally, she considers her daughter to be an ally with whom she will master her life. She is well supported by her aunt who has offered her to look after the baby while she finishes her studies. Annette has understood that she has a legitimate right to live her own life, to make her own decisions for her own good and that of her daughter!

The dialogues between Annette and me and the inner dialogues with her baby initiated this process of development and maturation in Annette. The baby also lived through extraordinary experiences, from total rejection in the beginning of her intrauterine life, to acceptance and love. The initial traumatisation could be transformed into happiness.


Without the APPA method Annette would have passed on to her daughter the same rejection from which she herself had suffered all her life. She allowed herself to question her mother's harmful attitude allowing her to dissociate herself from her mother's opinion.
Her story and her development demonstrate that the APPA method is indeed an effective tool of salutogenesis and prevention.