Transference Birth Fantasies and Narcissism

Over an additional period of five years, nine more cases were found to show patterns of unconscious birth fantasies centering around the end of the ninth month of treatment. The criteria for their selection are described. They had to show at least five indicators of birth fantasies within six weeks, plus or minus, of the end of the ninth month of treatment. The indicators were manifest dream content, dream symbolism, anal symbolism, and overt and, in the case of two males, covert references to birth. An absence from treatment for a week or more near the end of the ninth month may often represent the acting out of a birth fantasy and was taken as a presumptive indicator of the presence of a birth fantasy. More than half of the indicators centered within two weeks, plus or minus, of the end of the ninth month of treatment. Case examples are given of the various meanings of the birth fantasies. They included preoedipal separation problems, oedipal transferences, penis envy, jealousy of the female's reproductive ability, and attempts at mastery of trauma and fear of death. All of these categories of meaning may subserve attempts at

correcting a narcissistic disequilibrium. Unconscious birth fantasies at the end of the ninth month of treatment might be viewed as accompaniments of thrusts toward individuation as well as defenses against regressive narcissistic fusion.