In our book A Womb of Her Own (Routledge, 2017) author Meredith Darcy writes as follows:
Entering motherhood promotes deep psychological changes in a woman during pregnancy—a woman confronts psychological and physical transformations and prepares herself to become a mother in order to take care of a helpless and immature baby, in need of protection (Ammaniti, 2009). This process is strictly connected with the development of maternal representations of herself as a mother and of the future baby as a result of maternal projections, dreams, attributions, and conscious and unconscious fantasies. These maternal representations are rooted in the personal history of every woman from infancy to adolescence, specifically mirroring the actual life and the relationship with her own mother (p. 543).
Pregnancy as a Crisis
Grete Bibring et al. (1961) wrote: “Pregnancy is a crisis that affects all expectant mothers, no matter what their state of psychic health. Crises, as we see it, are turning points in the life of the individual, leading to acute disequilibria which under favorable conditions result in specific maturational steps toward new functions. We find them as developmental phenomena at points of no return between one phase and the next when decisive changes deprive former central needs and modes of living of their significance, forcing the acceptance of highly charged new goals and functions. Pregnancy as a major turning point in the life of the woman represents one of these normal crises, especially for the primigravida who faces the impact of this event for the first time. We believe that all women show what looks like remarkable, far-reaching psychological changes while they are pregnant” (p. 25-26).
“Real” Reactions to the Pregnant Therapist
The pregnancy of the analyst is a major event in the life of both analyst and patient. Patients have “real” reactions to the pregnancy, reactions that are relatively transference free, genuine, and realistic (Fenster,1986). Working with a pregnant therapist and the changes happening within the confines of the analytic space, is real, and is happening in present time, and is affecting both therapist and patient. Shifts occur in affective state, perspective, identity, and role—the therapist is going through a significant life changing event intrapersonally and interpersonally, in front of, and ultimately with, her patient. Fenster et al. (1986) stressed the significance of a facilitating change in the “real” relationship as a result of the therapist’s pregnancy. She believes that the analyst’s pregnancy can enhance the real relationship in an important way: that pregnancy provides a valuable opportunity for a mutually caring “real” relationship while enlivening the transference between patient and therapist.
The patient, traditionally “the one” going through the major life change while entering the treatment space, is now confronted with another person embarking on a life changing transition. The image of two people together in a life raft (Joseph Newirth, personal communication), managing the dangerous tumult of sea, while also surviving each other—these are the risks of a dynamic treatment while living a real life. Attempting to work through conflicts that arise during pregnancy may provide helpful and effective therapeutic experience for some patients while for others, the realness of what is happening within the room, may prove too difficult or painful to overcome or work through.
Ammaniti, Massimo & Trentini, Cristina.(2009). Psychoanalytic Dialogues, 19:537-555
Bibring, Grete L., Dwyer, Thomas F., Huntington, Dorothy S., & Valenstein, Arthur F (1961). A Study of the Psychological Processes in Pregnancy and of the Earliest Mother-Child Relationship—II. Methodological Considerations. Psychoanalytic Study of the Child, 16:25-72
Fenster, Sheri, Phillips, Suzanne B., & Rapoport, Estelle R.G (1986). The Therapist’s Pregnancy. Intrusion in the Analytic Space:
Hillsdale, NJ: The Analytic Press.
Newirth, Joseph, (2009). Personal Communication