This paper describes some aspects of the treatment, during her therapist's pregnancy, of a woman in her fifties who had been abandoned at birth and brought up in institutional and foster care. The patient's character defences were similar to those described in children brought up in institutions. (Spitz 1965)

I hope to convey some of the problems involved in emotional connectedness for this patient and hence the quality of the therapeutic relationship. I will go on to describe the patient's attempts to maintain an impersonal attitude to the pregnancy and how this broke down as more personal, infantile elements of her feelings proved to be too painful. The implications for the clinical management of this and similar situations are discussed.