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The patient to be described in this report experienced an episode of acute anxiety during the seventh month of her third pregnancy. She required immediate psychotherapy and later began a psychoanalysis. During the course of this psychoanalysis, after the birth of the child, she became pregnant again. The dreams and fantasies evoked by her conception, gestation, and delivery show how she marshaled her defenses and why she was so much disturbed by pregnancy. The psychoanalysis also helps to explain why psychotherapy during the initial emergency provided immediate symptomatic relief but failed to reach her basic problems.
The patient was an attractive and highly intelligent married woman in her late twenties. She had a sister a year and a half older; two younger sisters and her only brother were born by the time she was five. She did not at first mention her mother's first-born child, a boy who died at the age of three or four during her mother's pregnancy with the patient.
Her parents spent much of their time in active social life. Throughout her childhood and adolescence they went out almost every evening and usually entertained guests the few nights they stayed home. She never saw her parents express any affection for each other and became aware at an early age that something was lacking in their relationship. Her mother became a prominent figure in various philanthropic organizations and often spent the evening at a dinner party different from the one to which her father had been invited. Detailed arrangements made it possible for her mother to know exactly what each of the children was doing at every moment of the day. 'Mother