The pregnant therapist

The pregnant therapist and the psychotic client: A phenomenological understanding of the impact of the therapist’s pregnancy on the therapeutic process

“…Issues around sexuality never arose within this work, perhaps the clients correctly assumed that the therapist was in a heterosexual relationship, yet this common assumption made when a woman is pregnant may bring with it further complications around self-disclosure and perceived identity for women who are not in heterosexual relationships. Dyson and King (2008) warn that there are often less predictable changes that the therapist may experience such as increased vulnerability and anxiety and maternal preoccupation. These changes, which were experienced by the therapist, are likely to lead to an increasing reluctance to work with risk, as demonstrated with the early termination of work with R. and an unwillingness to explore the therapeutic difficulties.…”

“…As well as envy existing around the idea of being able to conceive Gottlieb (2006) extends the notion of envy to include a sense of jealousy of the baby, a fantasy that it is in a state of uterine bliss, protected from the cruelty of the world. It has also been argued that the envy and anger experienced by clients stems from a fear of being abandoned and neglected by the therapist in favour of the baby (Hjalmarsson, 2005), which supports Dyson and King's (2008) arguments around the notion of sibling rivalry. Raphael-Leff (2004) in exploring the themes around envy, anger and abandonment, identifies three main areas of unconscious processes present when the therapist becomes pregnant: firstly, the effect of the pregnancy on the patient, secondly, the effect of the pregnancy on the therapist herself and thirdly, the impact of the clients on the pregnant therapist.…”

“…The literature finds that client's reactions to a therapist's pregnancy are considered fairly consistent (Hurdman, 1999) though Korol (1995) warns that too often we underestimate the importance of therapist pregnancy for clients. The limited literature on the subject clearly shows that the same themes appear to consistently arise with anxieties around abandonment, neglect, envy, rivalry, jealousy and anger through transference and countertransference (Adelson, 1995;Deben-Mager, 1993;Dyson & King, 2008;Etchegoyen, 1993;Gottlieb, 2006;Grieser, 2006;Hjalmarsson, 2005;Mariotti, 1993). Grieser (2006) shows clearly that a pregnancy is experienced as an intrusion which alters the psychoanalytic space, with important themes arising around anxieties of abandonment, envy and rivalry.…”

“…Grieser (2006) shows clearly that a pregnancy is experienced as an intrusion which alters the psychoanalytic space, with important themes arising around anxieties of abandonment, envy and rivalry. It may be that the client experiences issues around sibling rivalry and envy arising from the therapist's pregnancy (Dyson & King, 2008). Gottlieb (2006), however, argues that this envy stems from the therapists' capacity to conceive and bear a baby.…”

“…Etchegoyen (1993) argues that the therapist's pregnancy intensifies transference and countertransference. Dyson and King (2008) argue that we need to understand the change in therapeutic relationship once the therapist discloses her pregnancy as moving from a dyadic to a triadic relationship. This idea is supported by Hjalmarsson (2005), who describes her own experiences as a pregnant therapist in which she experienced the foetus as a third person in the room.…”