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Difficulty in conceiving causes great emotional distress. Patients who turn to psychoanalysis or psychotherapy because they appear unable to conceive need to find a space to contain their emotional turmoil. They also, consciously or unconsciously, want to find a reason for their predicament, desperately wishing that, once this is found, they will be able to become pregnant. The concept of ‘psychogenic infertility’ supports this view. Some psychoanalysts whose subfertile patients have conceived following a particular piece of work done in treatment, have suggested that psychic conflicts can result in an inability to conceive. I have used the word subfertility to imply a difficulty to conceive, reserving ‘infertility’ to patients who cannot conceive at all.
Subfertility has been studied from different points of view, and different psychoanalytic models have highlighted various aspects of it. Langer for instance, in her 1958 paper ‘Sterility and Envy’, posits that in sterile women there is a failure of identification with a good fertile mother. She reports that, in the history of several infertile patients, traumatic events in the relationship with the mother can be found. She observes that in such cases it is possible to discern the way the patient typically had experienced her mother as weakened or destroyed by the child's own envious attacks – now adult, the patient
identifies the wished-for baby with an envious and destructive object and unconsciously rejects the baby, through vaginismus, infertility, or miscarriage.
More recently, Allison (1997) has suggested a different set of problems. He agrees that traumatic events are often present in the infertile patient's childhood. In particular he notes the significance of the loss of a sibling, or of having a disabled (male) sibling. This, he suggests, precludes the development and working through of jealousy and competitiveness and interferes with the capacity to become independent from mother, who is seen as in need