Discussion of the Case of Ellen

When approaching these clinical hours I found myself focused on the organizing themes of pregnancy and prenatal states of mind in the transference. Additionally, the importance of the confusion about pregnancy, both mental and physical, as they appeared in the moment-to-moment evolution of the interaction in the sessions are essential to the way I think about this psychoanalytic encounter. My own listening is to what I would call the micro-splitting which is often a barrier to contact and listening-through-a-barrier as one of the forms of evidence of what I am referring to as a prenatal states of mind as they are demonstrated within the transference. What I mean by conflation of sexual and verbal intercourse will become clearer when the clinical material is presented. I quote material extensively to bring the evidence to which I am referring directly in front of the reader's eyes, so that the reader can match my formulations with their own experience of the material.

Mental pregnancy can occur when there are two individuals in contact with each other who have open minds so that the conversation is true intercourse. The material is received and responded to on point. The growth of mental processes is dependent on this interaction. With a live person there is the communication problem of affect having too great a load on the receiver who must be able to bear the experience unless interrupted by primordial superego sources that cut off contact. This prevents intercourse which avoids the pain of the incipient mental pregnancy that occurs. The processes that lead to mental birth are not as clear, but the process of splitting and avoidance which prevents the approximation conversationally that is necessary is readily demonstrable. The analyst must be able to analyze the micro-splitting that evades contact and leads to elliptical communication. It will be clear in the material that mental birth and physical birth are conflated as well as sexual and conversational intercours