Contemporary Psychoanalysis, XXVI, 1990

The Avoidance of Countertransference Awareness in a Pregnant Analyst. Ruth R. Imber. Pp. 223-236.

Pregnancy, like serious illness, is a stress which causes an analyst to be self-absorbed and vulnerable. In such a state, there is increased anxiety and defensiveness about highly charged, especially negative, patient communications. The author reviews the literature, which she notes is sparse; this is possibly in itself an example of resistance to countertransference awareness. The broadest definition of countertransference is used by Imber, and she supports the view that countertransference stimulated by the patient is an important tool in furthering the analytic process so long as it is properly analyzed. However, since pregnant analysts are prone to defending themselves against awareness of negative countertransference, they are often temporarily unable to accomplish this analysis. It is hypothesized that the reason for such avoidance is the fear of being vulnerable to the destructive potential of envy and aggression. Pregnant analysts are particularly afraid of hatred and destructive wishes, in both themselves and patients. Their own aggression may be perceived as in "conflict with the task of becoming more maternal and nurturing," and that of their patients evokes fears, such as of bodily harm and robbery. In an excellent clinical example, the author discusses her female patient whose longdenied competitive, envious transference feelings erupted during Imber's pregnancy, culminating in the patient's telling the horror story of her own complicated pregnancy. This represented a sadistic "acting in" because of the anxiety-evoking content, and resulted in a negative countertransference which the analyst denied until several months after her delivery, when her sense of vulnerability was lessened. As a result, she was unable to analyze the patient's negative transference until this later date. Imber discusses the origins of her reaction, including those aspe