pregnancy in therapy

Wrestling with Fertility in Analytic Therapy

We have written before about what happens when the veil of privacy lifts between a psychoanalyst and her patient, and about how such personal disclosures (by the therapist) can change the tenor of “the room.” This recent piece explores one of the most common issues that prompts therapists into candid conversations : pregnancy. As the author describes:

Traditional psychoanalytic theories envision the therapist as a blank slate on which patients project their thoughts and fantasies, a distant expert interpreting the patient from behind an inscrutable facade. Patient’s concerns are seen as problems the doctor can “fix” through psychological suturing. Contemporary psychoanalytic viewpoints, by contrast, have given rise to a very different understanding of the therapeutic alliance, one in which the relationship itself is ultimately what’s curative. But the therapist’s quasi-anonymity remains a central tenet. Patients might inquire about a therapist’s personal life, but unless it benefits the patient’s growth to answer the question directly, the therapist usually explores what the question means to the patient.

In practice, such questions become harder to avoid when a visible pregnancy enters the therapeutic space. The author of this piece wrestled with a number of approaches to manage and explore the feelings her growing belly inspired, but the responses for her and patients were often more personally charged than other conversations.

After negotiating a heartbreaking miscarriage and another pregnancy, the author describes how she has come to a sense of accommodation about discussing some personal issues surrounding pregnancy and childbirth with her patients, and how the work is often more beneficial for it:

There was a time when I would have reflexively asked Maya what my maternity might mean to her. But instead I considered revealing a small but profound piece of my life. What I hope to offer my patients now, in both subtle and demonstrative ways — shared and silent — are the arduous lessons learned through personal pain and reflection. Far from a blank slate, but no longer a focal point of the therapeutic relationship, I’ve landed somewhere in between, a much more ideal middle ground.

“Yes,” I began my reply to Maya. “I have two children.”

Psychoanalytic therapy is a deep and lasting process such feelings are worth exploring and where patients can make great strides in a safe space. To speak with an expert psychotherapist in New York today, contact PPSC.