The Impact of the Analyst's Pregnancy on a Vulnerable Child a Case with Discussion by Anna Freud

This essay is based on my work with Sam, a six-year-old boy whom I analyzed as my first child control case when I was an advanced candidate. In 1966 I presented the first year and a half of my work with Sam to Anna Freud when she visited the Chicago Institute for Psychoanalysis. (Her discussion of the case is included in the italicized sections.) Anna Freud's discussion focused on explaining Sam's intense reactions to my pregnancy as a retraumatization: a repetition in the analysis of a remembered danger situation that was as traumatic for him as his mother's pregnancy with his 3-year-younger brother. This retraumatization was distinguished from a transference repetition motivated by the child's repetition compulsion. I shall present clinical material based on my original work and a retrospective discussion that reconsiders the issues of trauma, retraumatization, and the effects of these factors on transference and analyzability. I will argue, as an alternative understanding of the clinical picture, that the extremity of his reaction is best understood as a revival within the transference of his original conflicts and his defensively organized attempts at solution, and that this transference partially yielded to analytic work.

Sam was six years old when referred to me. His mother and father worried about his poor school adjustment with peers and teachers alike, subpar academic achievement despite superior intelligence, constant provocative battles at home, and nightly enuresis. The onset of his symptoms, when Sam was three, coincided with his mother's pregnancy with Adam, Sam's brother, and with Sam's entry into nursery school.

Before Sam's birth, Sam's mother lived unhappily with her first husband, an engineer, in Europe. They had one child, Richard. Although initially hopeful about