Clinical Issues for Pregnant Psychoanalysts

Turkel, Ann Ruth

doi:10.1521/jaap.1.1993.21.1.117

Cited by 10 publications

(4 citation statements)

References 9 publications

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“…She notes that longterm patients are particularly sensitive to and unable to verbally cope with feelings of loss, and such experiences are often associated with regression, acting out and decompensation. Turkel (1993) substantiates the view that severely disturbed patients are more likely to act out in response to their therapist's pregnancy. Berman (1975) demonstrated a statistically significant increase in the reported frequency of acting out when therapists were pregnant.…”

Section: Patient Reactions To the Therapist's Pregnancysupporting

confidence: 57%

Review of the Literature

Whyte

2004

Psychoanalytic Psychotherapy

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The first paper written about the effects of the analyst's pregnancy on her patients was by Hannet (1949). In this paper the author described the responses of several of her patients to her miscarriage and she reported that each of her patients reacted in the transference according to their individual psychopathology and investment in the treatment. Some 17 years elapsed before there was another paper on the subject. Van Leeuwen wrote in 1966 about one male patient's response to her pregnancy, as an illustration of the rarely acknowledged phenomenon of pregnancy envy in men (Van Leeuwen 1966). In 1969, Lax offered a substantial paper in which she noted the striking paucity of a discussion on this topic in the psychoanalytic literature to date. She went on to describe the specificity of the responses of six of her patients to this special event in the analysis. Like Hannet (1949), she observed that these responses were linked with 'the reactivation of those aspects of the infantile conflict which were most significant for the development of (the patient's) pathology' (Lax 1969). The reactions of male and female patients were noted to be different. Male patients showed a relative paucity of responses and denied the existence of the pregnancy for much longer than female patients. When they did acknowledge it, this recognition was followed by 'minor turbulence in the transference' and isolation was used as the main mechanism of defence. For the women, the pregnancy evoked 'a profound transference storm' and identification with the analyst was the most commonly used defence. Lax (1969) postulated that these gender differences were related to the different psychosexual development in boys and girls. Finally Lax addressed potential countertransference reactions that are more likely to appear at this time in the treatment, stemming from the analyst's own personal history of her response to pregnancy. She spoke of the need to be aware of these countertransference responses in order to be able to guard against them! In these early papers the authors were suggesting that the event of the therapist's pregnancy largely constituted an interference in the treatment process. It heightened separation anxieties and symbiotic longings and apart from intensifying the particular transference pattern, it was felt to have little therapeutic importance.

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Section: Patient Reactions To the Therapist's Pregnancysupporting

confidence: 57%

Review of the Literature

Whyte

2004

Psychoanalytic Psychotherapy

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“…Ms B, however, was unable to sustain the analysis in the long term, breaking off her treatment after a period of her own gestation during which it was difficult to know whether her apparent changes represented real growth and creativity or an envious imitation of my own which she could not tolerate and had to spoil, or perhaps both. This highlights the risks encountered in the treatment of patients with pre‐oedipal disturbance for whom the analyst’s pregnancy may be an insurmountable challenge to their pre‐existing narcissistic object relations, and the treatment is likely to break down (Domash, 1984; Turkel, 1993). Finally, pregnancy may also of course test the stability of the analyst’s own body image, which will inevitably colour her countertransference and reactions to patients in complex and personal ways that I have only alluded to in this paper.…”

Section: Resultsmentioning

confidence: 99%

“…It is also consistently noted that common themes about identity, sexuality, abandonment, sibling rivalry, trust, and withheld secrets emerge in treatment when the analyst is pregnant: these occur in response to the real situation of the analyst being pregnant, but reflect unconscious dynamically determined aspects of the transference. More recent papers also focus on the specific technical dilemmas that arise during the psychoanalytic treatment of patients when the analyst is pregnant, such as the timing and mode of disclosure, and the management of the analyst’s maternity leave and its aftermath (see also Gerson, 1994; Imber, 1995; Turkel, 1993; Uyehara et al ., 1995). I could find no papers, however, that specifically address the subject of this paper, namely, how the patient’s body image is affected by the analyst’s or therapist’s pregnancy.…”

Section: The Pregnant Analystmentioning

confidence: 99%

Seeing, mirroring, desiring: The impact of the analyst’s pregnant body on the patient’s body image

Yakeley

2013

The International Journal of Psychoanalysis

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The paper explores the impact of the analyst's pregnant body on the course of two analyses, a young man, and a young woman, specifically focusing on how each patient's visual perception and affective experience of being with the analyst's pregnant body affected their own body image and subjective experience of their body. The pre-verbal or 'subsymbolic' material evoked in the analyses contributed to a greater understanding of the patients' developmental experiences in infancy and adolescence, which had resulted in both carrying a profoundly distorted body image into adulthood. The analyst's pregnancy offered a therapeutic window in which a shift in the patient's body image could be initiated. Clinical material is presented in detail with reference to the psychoanalytic literature on the pregnant analyst, and that of the development of the body image, particularly focusing on the role of visual communication and the face. The author proposes a theory of psychic change, drawing on Bucci's multiple code theory, in which the patients' unconscious or 'subsymbolic' awareness of her pregnancy, which were manifest in their bodily responses, feeling states and dreams, as well as in the analyst s countertransference, could gradually be verbalized and understood within the transference. Thus visual perception, or 'external seeing', could gradually become 'internal seeing', or insight into unconscious phantasies, leading to a shift in the patients internal object world towards a less persecutory state and more realistic appraisal of their body image.

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“…On remarque aussi régulièrement que les thèmes habituels tels l'identité, la sexualité, l'abandon, la fratrie, la rivalité, la confiance et les secrets apparaissent dans le traitement lorsque l'analyste est enceinte, en réponse à la réalité de la grossesse mais aussi en lien avec les aspects dynamiques inconscients du transfert. Des articles plus récents insistent sur les difficultés techniques spécifiques du traitement pendant la grossesse de l'analyste, telles que le timing et la manière d'annoncer la grossesse, la gestion du congé de maternité et ses conséquences (voir Gerson, 1994 ;Imber, 1995 ;Turkel, 1993 ;Uyehara et al, 1995). Par contre je n'ai trouvé aucun article qui traite du même thème que le mien, à savoir comment l'image corporelle du patient est touchée par la grossesse de l'analyste ou de la thérapeute.…”

Section: L'analyste Enceinteunclassified

Voir, refléter, désirer : l'impact du corps de l'analyste enceinte sur l'image corporelle du patient

Yakeley¹

2014

L’Année Psychanalytique Internationale

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Clinical Issues for Pregnant Psychoanalysts

Cited by 10 publications

References 9 publications

Review of the Literature

Review of the Literature

Seeing, mirroring, desiring: The impact of the analyst’s pregnant body on the patient’s body image

Voir, refléter, désirer : l'impact du corps de l'analyste enceinte sur l'image corporelle du patient

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