In our book A Womb of Her Own (Routledge, 2017) author Meredith Darcy writes as follows about her patient as her own pregancny progressed:
Abby was angry: she was experiencing real feelings towards me and was confused and scared about what that meant. Now I was pregnant and becoming a mother—Abby began to feel hurt. She claimed to feel tricked, that I had “allowed” her to connect with me, knowing full well that I was trying to conceive a child and would be leaving her. Her feelings of loss and abandonment were great; she felt angry, hurt and rejected by me. Understandably, there is intrinsic loss in any break in treatment, but she was also mourning my changing identity—she would cry, calling me “little Meredith.” She would sob, “Little Meredith is having a baby!” Evidence of Abby’s early disruptions in care: parental unavailability, early rejection and emotional misattunement and neglect (A. Slade, 2000) was now being triggered by feelings of abandonment and grief in response to our work together and my impending leave.
Was there room for us both, Little Meredith and Little Abby?
I had a dream around this time (I was 6 months pregnant): I was in a cafe in NYC—I saw a very tall, unidentified woman whose name began with A. I was angry with her–she was acting petty and immature. I was frustrated and yelled at her, “leave me alone!” Suddenly, A became my waitress, and she would not bring me my lunch. I waited an hour, and then complained to the manager. I was furious and embarrassed. In the dream I thought, why had I not complained, spoken up earlier?! Why do I feel I am always so angry and why do I feel bad things are always happening to me? I felt like an outsider: isolated and alone.
This dream seems to express my feelings of intense powerlessness, regarding my infertility, my family, and my unexpressed anger towards Abby–why had I not spoken up? Did I want Abby to be more “helpful” or more accepting of my maternity? More generous and less self-serving? There was a dynamic being played out between Abby and me similar to those between my mother and me I–both women were very needy with a similar age gap. It might have been too much at the time for me to be able to pull back, see her objectively, and identify her neediness. In the countertransference, I am once again the “child” to the needy and attacking mother. And now pregnant, the question is: who is really taking care of whom? (E. Toronto, personal communication).
Working with Abby, I had begun to feel ashamed of my humanity: my warmth and my softness and was unaware of the depth of my anger towards her. Like in my dream, I felt ashamed by my anger and frustration. I couldn’t tolerate my hatred of Abby, triggered by her attacks, which flooded me with shame. Joe Newirth aptly explains how difficult it can be for therapists to deal with their own sense of shame: “It’s a very powerful thing that inhibits us, to enter into our own feelings of ‘I hate this person.’ In countertransferential situations we are identified with a patient’s unconscious, but we are often bringing up our own shameful experience. It’s a very powerful experience for most of us, because we’d rather control it. So we learn how to be good.”
Newirth, Joseph, (2009). Violence and Aggression in the Consulting Room. Psychoanalytic Perspectives, 6:1-21
Slade, A. (2000). The Development and Organization of Attachment: Implications for Psychoanalysis. Journal of the American Psychoanalytic Association, 48: 1147-1174.
Toronto, E. (2017) Personal communication.