Review of the Literature

The first paper written about the effects of the analyst's pregnancy on her patients was by Hannet (1949). In this paper the author described the responses of several of her patients to her miscarriage and she reported that each of her patients reacted in the transference according to their individual psychopathology and investment in the treatment. Some 17 years elapsed before there was another paper on the subject. Van Leeuwen wrote in 1966 about one male patient's response to her pregnancy, as an illustration of the rarely acknowledged phenomenon of pregnancy envy in men (Van Leeuwen 1966). In 1969, Lax offered a substantial paper in which she noted the striking paucity of a discussion on this topic in the psychoanalytic literature to date. She went on to describe the specificity of the responses of six of her patients to this special event in the analysis. Like Hannet (1949), she observed that these responses were linked with ‘the reactivation of those aspects of the infantile conflict which were most significant for the development of (the patient's) pathology’ (Lax 1969). The reactions of male and female patients were noted to be different. Male patients showed a relative paucity of responses and denied the existence of the pregnancy for much longer than female patients. When they did acknowledge it, this recognition was followed by ‘minor turbulence in the transference’ and isolation was used as the main mechanism of defence. For the women, the pregnancy evoked ‘a profound transference storm’ and identification with the analyst was the most commonly used defence. Lax (1969) postulated that these gender differences were related to the different psychosexual development in boys and girls. Finally Lax addressed potential countertransference reactions that are more likely to appear at this time in the treatment, stemming from the analyst's own personal history of her response to pregnancy. She spoke of the need to be aware of these countertransference responses i