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When the Therapist Needs “Mother”

In our book A Womb of Her Own, author Kristin Reale describes her own depersonalization and dissociation as she returns to her practice following her delivery.

I was uncertain about how I felt returning from my leave to work with her. I knew it would be intense, and I had an obscure fantasy of needing some kind of armor so that she didn’t completely invade me. The morning we met, a week into my return, I was feeling calmer and what I thought was a sense of preparedness to accept her level of dependence, ready for what she was to toss onto my lap. Looking back, as with my newborn, I think I was more intellectually than emotionally prepared for the sheer intensity it would bring. As I sat with her those first moments, I was immediately struck by how much hostility she had toward me. All in one instance it felt that she wanted to take my mind from me once again. I listened, I joined, I quietly nodded, I responded, and I tried my best to empathize with her experience. But I felt trapped and that nothing I said or did could make space for us to relate. 
 There was no transitional space.

The Therapist’s Own Fear and Anxiety

All at once, I felt the waves of anxiety. The fear came charging into me. I was terrified I was going to jump out the window. Literally. I did not want to jump out the window, but I wasn’t completely certain my body wouldn’t thwart itself out the window without my choosing. I was becoming unintegrated. This feeling, difficult to articulate, was absolutely tormenting. I was depersonalizing, dissociating. There I sat on the 26th floor of a skyscraper, a foot from an open window on a gorgeous crisp fall day, feeling this paralyzing separation from myself. I looked down at my hands and forced them to cling to the leather arms of my chair. “Hold on, Kristin, you have to get a grip.” I was very aware all at once that Sarah’s spilling of her mind needed desperate containment. I needed to begin to give my self space to think, to symbolize for her, for us, her anger, my anger, my fear, her hate of me and my motherhood, my hate of her needing me so and driving me crazy.

I had to conjure my own transitional space. My desire to literally escape, jump out the window, was a concrete manifestation, like those first weeks with my newborn, who also like Sarah, couldn’t think yet, couldn’t symbolize. Sarah was just “parts” coming at me, needing integration. Knowing that I could indeed “do” something with this all in my mind, partially soothed my anxiety and the need to flee. As difficult as it was, inch by inch, I pulled my mind away from the window, away from escape, and back into time. Over the course of the next few months in my practice, I would experience a similar reaction of wanting to jump out the window while sitting with several of my more disturbed patients. Finding my grip became a new familiar part of my practice.

Mother ‘s Need for “Mother”

My journey into pregnancy and motherhood was life-changing both personally and professionally beginning with the labor and delivery. I had not realized, for instance, how tied I was to my midwife. While my husband and doula were “great” and doing everything they could to support me, what I did not realize was how psychologically connected I felt to my midwife as my protector, my eye-to-eye support, my mother-substitute, and how much I needed her there with me as my labor experience intensified. My own attachment system was being deeply triggered. My complicated psychological history and current needs were calling out: the matrix of a difficult maternal relationship with my own mother, a complicated and trauma filled individuation process earlier in my life, and a need to develop an ever more varied emotional world that made space for ambivalence, anger and need came together to form my very own postpartum depression.

What I now understand was that my craving for an attuned mother my entire life would come to a head during labor and the first months of motherhood, exposing me to the deep fissures that had occurred as a result of being psychologically dropped again and again as a baby and child. I was never quite “held” due to my own mother’s intergenerational trauma and those fractures were to be revisited again and again in the most painful and unexpected ways. No matter how much “work” I had done on myself psychologically in the decade and a half prior, I now believe that the surge into new motherhood provoked my concealed wounds like nothing before could reach. My being the independent, “parentified,” well-trained therapist I was, I was unaware of some of the hidden needs that lurked within me until they were hemorrhaging. Feeling frightened without that moment to moment attuned care from my midwife, I believe was the first “break” in my mind in which I experienced a lost, un-held devastating aloneness that mimicked trauma from my childhood. I was not conscious that I would need her to such a degree to protect me from sinking into my abandoned dark well.


When the Therapist Needs “Mother”

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. (2019). When the Therapist Needs “Mother”. Psych Central. Retrieved on August 8, 2020, from


Last updated: 20 Dec 2019
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