Effect of Therapist's Pregnancies on Transference and Countertransference: A Case History

Rachel began therapy with me when she was 20 years old. My initial impression of her was of a typical Kleinian “paranoid-depressive” character (Klein, 1975). Though she complained of feeling depressed, it was because she felt she was persecuted by someone else's hatred, rather than because she thought there was something wrong with her. I quickly became her persecutor in the transference. Rachel experienced me almost from the beginning as angry, critical, and rejecting. These turned out to be transference distortions, derived from what she sensed were her mother's “true” feelings about her, even though consciously she pictured mother as loving and concerned. Thus the kernel of truth in her paranoid projections was the historical attitude of mother.

Mother is the principal character in the early part of the therapy. She so dominated the first year of our work that I knew next to nothing about anyone else in Rachel's life, including her father and brother, nor did I learn much about her personal history. Mother finished her own lengthy five-times-a-week analysis at the same time Rachel began treatment with me. This may have had some bearing upon the fact that Rachel referred to her therapy from the beginning as her “analysis,” even though initially it was only twice weekly, and to me as her “analyst.” Both parents were familiar with psychoanalysis.

I knew her father was an administrator in a city school system and that his career was much less distinguished than that of mother who