A therapist's pregnancy is bound to provoke profound conflicts in all patients, particularly those relating to envy, exclusion and loss as infantile aspects of the patient and their relation to the maternal object are revived. This paper explores the impact of the therapist's pregnancy on two patients for whom the experience was felt to be catastrophic. I suggest that in their early efforts to adapt to an inaccessible, disturbed and disturbing object who could not face reality or cope with life, these patients were compromised in their own ability to accept the facts of life and moreover to bear the frustration of exclusion, representing for them as it did, total inaccessibility. The pregnancy was so hated and distorted that it seemed to take on the meaning for them of a cruel ‘mad’ idea.