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The mother of an infant born with transposition of the great vessels was started in weekly psychoanalytically oriented psychotherapy after observation indicated that she was becoming increasingly withdrawn from her infant boy. Feelings of guilt and shame from various periods in her life were revived and focused by her current life
situation. She expressed fear of her death wishes toward her infant. As these feelings emerged and were partially worked through in psychotherapy, the longed-for perfect child could be mourned, and the patient was able to assume a loving, maternal role which promoted her child's adaptation. The relative availability of the patient's fantasy life in this therapy is presented and viewed as supporting the theoretical position that pregnancy and the postnatal period predispose to a greater accessibility to otherwise unconscious aspects of mental life. The broad and important implication of the article and the theory is that a psychoanalytically oriented consultant-therapist is strategically placed for achieving wide-ranging and long-lasting results with brief interventions in obstetrical and neonatal settings.