Psychoanalysis During Pregnancy: The Effect of Sibling Constellation

In her chapter on pregnancy, Helene Deutsch (1945) wrote (p. 161): “If it were possible, as in a laboratory, to isolate the phenomenon of pregnancy from all the influences of past and present environment, and to observe directly all the stirrings of the soul that go hand in hand with the development of the fetus, we should probably learn much more about the subtle correlations between mother and fetus.” But psychoanalysis is not a laboratory, and women do not enter it solely to examine the psychological processes of pregnancy. Even if they did, it is likely that, as Deutsch says of her analysands, their fantasies and dreams would be influenced more by the analytic situation and the analyst's attitude than by the fact of pregnancy. Deutsch goes on, however, to express “ … the distinct and very curious impression that the various ontogenetic phases of the fetus affected the psychoanalytic material, especially the dream life of the pregnant woman.”

The account that follows is of a brief psychoanalysis that demonstrates some of the “subtle correlations between mother and fetus” that Deutsch suggests. In particular, the mother's identification with a fetus whose sibling position corresponded to her own seemed especially helpful to the analytic process of unearthing an identity fragment from which she could draw considerable