Secrecy Surrounding a Pregnancy and its Effect on the Treatment of a Seven-Year-Old Child

In this paper I will describe the first year of treatment of a rather narcissistic boy when a fourth child was conceived and born into the family. The mother withheld this news from the child and I will show how I was drawn into the secrecy and deception; and how this had a profound effect on my freedom of movement with the child and on my capacity to help him.

A situation arose in the treatment which reflected elements in the family dynamics, and which prevented Alex (as I shall call him) from working through his oedipal difficulties and contributed to his learning problems. The child himself had a propensity for tricky and deceptive behaviour, and a suspicious and tricky atmosphere came to pervade the treatment and was evident in his material. I became identified with both the deceiving mother who colluded with the child's oedipal fantasies, and with a weak father who was unable to help him with the problematic and involved relationship with his mother. This boy used defences of omnipotent denial, omniscience and pseudo-maturity to sustain his oedipal fantasies. I will show how these were threatened by the pregnancy itself and by the way the knowledge of the pregnancy was used.

The D. family was middle-class and Jewish and the parents presented as caring and attentive, with firm ideas about how children should be brought up. They had no television, and comics and guns were forbidden. Great emphasis was placed on academic achievement, and although I did not have the impression that this was excessive, there was more pressure on my patient, Alex, in this and other respects as the oldest and only son. For example, he went to a somewhat rigid and striving Jewish school, while his two sisters attended a more relaxed local authority school. Alex was expected to be grown up and polite and this led to a neglect of his infantile needs. For instance, when the new baby arrived Alex was moved from his room and given a corner of a downstairs room where Mrs. D. ran a pl