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Most analysts who have been in practice for more than a few years have encountered situations that challenge the “rules” that we felt we learned during analytic training about the use of the couch and other elements of the analytic frame. Having experience in both the ego-psychology point of view and the British object-related point of view, and thinking of myself as quite clear and firm in my expectations of patients using the couch, I have encountered in three rather similar cases a puzzling situation that colleagues may find of interest: twice during my eight years of study and practice in London, and again upon returning to practice locally following my London stay, an analytic patient has asked insistently to bring her newborn baby to her analytic sessions for what was in each instance a period of several months. On each occasion, both at the time and in retrospect, I felt that allowing this parameter was quite appropriate and here, focusing in detail upon the third case encountered, I will detail why. As I am sure that colleagues have faced some of the same pressures from patients, I hope my notation about this clinical situation will be of interest.
A woman (whom I call P) in her mid-thirties, an interior decorator deserted by her husband, came to analysis for a number of reasons, but it soon became evident that her core issue revolved around the central feeling that no one understood or wished to understand her feelings and her point of view. This concern became evident in the transference in many ways, but it was especially evident around the time of