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January 19, 1976. OBJECT LOSS AND THE WISH FOR A CHILD. Merl M. Jackel, M.D.
Elaborating on his previously described thesis that a preoedipal wish for pregnancy can occur in response to separation from the analyst, Dr. Jackel offered a series of clinical observations which demonstrated that this phenomenon also occurred outside the analytic situation. He felt it was a response
to object loss in general and represented an attempt on the part of patients to re-establish within themselves the mother-child symbiotic unit. Clinical illustrations of the variety of ways in which this wish could be evidenced included fantasies of out-of-wedlock babies, dreams of postpartum phlebitis, interest in creativity, difficulties with contraception and actual pregnancies coinciding with vacations of the analyst, and psychophysiological changes such as paradoxical lactation at the time of termination, or anal abscess in a male patient with anal pregnancy associations.
Dr. Jackel's review of the literature reinforced his view that this phenomenon derived from certain identificatory stages in the course of early separation-individuation developments. The patient (child) identifies with the childbearing omnipotence of the preoedipal mother and thus tries to avoid the helplessness engendered by the threat of separation. Since other transference wishes may overlap with this preoedipal derivative, additional meanings of the wish for a child may include wanting to give mother a child, to bear a child for father, or to have father's penis, for example. Anna O's pseudocyesis after leaving Breuer and Breuer's prompt countertransference impregnation of his wife were also cited.