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This paper is about an 18 session, brief focal psychotherapy with a five month pregnant woman, previously infertile, who suffered from an intense anxiety state and depression following horrific nightmares of murdering her yet unborn baby. This case confirms what D. Pines (1982) wrote in her paper, ‘My analytic experience has led me to believe that there is a marked distinction between the wish to become pregnant, and the wish to bring a live child into the world and become a mother’. In the case of the patient I am going to describe, a tremendous hostility towards her own mother and a conscious wish to become pregnant were linked with unconscious fears that if she were to become a mother, she would hate her child enough to kill him.
The working through in the transference of her hostility and resentment towards her mother and the analysis of anxieties of a persecutory nature allowed an amelioration of the clinical picture and the avoidance of a likely puerperal illness of some severity.
The experience of pregnancy reactivates conflicts unresolved in previous deve lopmental stages and the temporary regression to a primary identification with one's own mother may bring about primitive fears of merging with her, with a consequent threat of loss of identity. In the patient I shall be talking about, early separation from her own mother determined a partial failure of self/object differentiation and the increase of primary hatred and hostility. After she became pregnant, the inevitable regressive identification with a hated mother produced loss of boundaries with consequent confusion; through projective identification, she felt she was at the same time her own mother, herself and the foetus she was carrying.
Primitive anxieties of merging and losing one's identity, and uncontainable hatred and guilt, become remarkably accessible in these patients and deep interpretations can be made from the very first session. Indeed, with less disturbed pregnant women, one or t