The Pregnant Therapist: Reflections from the Point of View of the Therapist

Last week I had some surprising reactions of my own to my own post, when I saw my post on “The Communicated Stereotype”, which I was very excited about. Since starting this blog, I have been looking forward to being a guest blogger to other sites and especially to this particular one. Perhaps due to my going back to it and rereading it for edits and slight changes to be a good fit for Anastacia Kurylo’s blog, maybe a few hours after posting the announcement about it, (see most recent post), I was surprised by some interesting reflections that came to me without my thinking about it.
First, I wondered about my tone. Did I come across as seeming angry, more importantly, did I come across as seeming angry at my patients?
Now for some personal information about my own pregnancy and experience as a pregnant therapist, which was what inspired me to want to write in depth about it here and plan a workshop about it. This many part topic has been percolating in me for a long time, in the form of a workshop I would love to do for young therapists who haven’t gone through pregnancy or are pregnant as a topic to learn about that is not taught in any kind of art therapy, psychology or psychoanalytic program as far as I know…
When I was pregnant, from around the end of December 2006 until the beginning of Sept 2007, I did notice heightened feelings of anger that popped up unexpectedly throughout that strange time. Of course I had other feelings, but somehow one of the good sides of being in this strange 9 month state is allowance for being a mad angry pregnant lady!
(I also just remembered that while I have never been in therapy with a pregnant therapist, my last year in grad school, my onsite supervisor was pregnant and left before the end of my internship. The person who replaced her was very different and had many find qualities, but I could see or accept none of them. I was mad at my former supervisor for leaving and considered the new one an imposter. I was very aware I felt quite angry and abandoned in my last experience working at an internship before going through the scary metamorphosis of becoming a graduate and a “real” therapist myself…)
The first full prefnancy is a strange in between time for a woman; you are not a mother yet, but you are in process of turning into one, and it all takes place inside your body, a very private place. Of course your body is ironically the first thing people notice about you when they meet you- what you look like… Pregnancy is a lot of things but it is foremost visual: they know you’re pregnant when they see the baby bump and growing belly. There is a certain strange loneliness about the state of being pregnant; you may be with a partner or not, but sometimes being with a partner brings this solitary feeling to the forefront; your partner is also about to have a baby, but s/he is not pregnant. Only you are in a constant state of flux, change, metamorphosis. Even though you have the constant companion of the growing entity inside you, you can still feel very alone and separate from it, even taken over and pushed around. This stuff in your womb will eventually push all your surrounding organs into weird places. Even at the beginning, it’s existence can cause pain, discomfort, strange weird cravings and a feeling of being invaded by something that is totally not in your control. You are housing an alien who is about to become your mystery lovely but dreadful new roommate. As one woman said, she was not prepared for an unpredictable roommate that wakes you up all night long, has strange ways of eating and screams in such an awful way that they actually record that noise for torturing prisoners!
There are many other things to contend with psychologically as well as physically. There is your own relationship with your mother, dead or alive or mother(s) if you are adopted, whether you know your biological mother or not. For those who do not, this is an intense process, as you are about to meet your first blood relative, and of course, being pregnant brings up all kinds of feelings around your own birth…
Anyway we are focused on the part before you receive your baby. As soon as you become pregnant, your body is not your own. I know some pregnant women who really embraced this state if being, “I now have an excuse for not caring what I eat, and finally society actually wants me to gain weight and have a huge bulge, etc…” It is sort of liberating in our looks conscious constant fad dieting society obsessed with the latest trend in how bodies “are supposed to look” to waddle down the street in a tight shirt that emphasizes the big baby house you’re carrying around…
I have strayed far from the original topic, the angry tone of a therapist looking back at what it was like to be a Pregnant Therapist. So, some of the pregnant therapists in private practice that I talked to while I was pregnant and after reported that they were relieved when their patients figured out or sensed they were pregnant early on in their pregnancy. It seems that there is an unconscious process going on here. Before disclosure of the pregnancy, the therapist is living with a secret in the room, sometimes she is also keeping her pregnancy secret outside of her office. Some even have the strange situation of more of their patients knowing about it than the people in their personal life. The unconscious process that seems to go on in this kind of game of when and how will each person figure it out, is that during the time that you decide you are somehow “ready” for your patients to figure out you are pregnant often coincides with when they feel they have permission to mention it to you. I know of therapists who had patients ask them if they were pregnant within the first 8-12 weeks, and obviously not from looking that different, although perhaps pregnancy immediately affects how you move and feel about your body… These therapists were relieved to get the processing started and felt more relaxed with their patients because of not anticipating and having the time to obsess about each individual’s possible reaction and having a lot of time to prepare for maternity leave.
I had quite the opposite experience. In my personal life I threw caution to the winds and told everyone I knew way before week 12. At work, I dreaded my patients’ finding out and especially was pleased at my ability to sometimes even forget for an hour that I was pregnant. I had a lot of imaginary conversations about it in my head. So I had to contain a lot of anxiety around not wanting my patients to notice any changes and wanting to remain “not pregnant” as long as possible in my studio office. As is often the case with our first explanations of our feelings and defenses with our patients, I framed this prolonging of the ” baby” intruding on the sessions, as being primarily connected to my protective feelings towards my patients, especially those with trauma histories. I imagined I was protecting them from the trauma of dealing with an upcoming separation and kind of “abandonment” over which they have no control. (Of course I was partly projecting my own feelings about my abandonment of my “therapist self” and sudden termination of my work with them. Ironically for me, at some point I realized that work with my patients functioned as a refuge from the quite traumatic experience of pregnancy. Every pregnant woman goes through some kind of identity crisis with the first time they become a mother. Basically your identity is being transformed from one of daughter, girlfriend, wife, friend, etc. to being a Mother. It IS a big deal. For me, I definitely wanted that baby, but I also felt myself undergoing a strange transformation that definitely freaked me out. Was this baby as it grew and took over my body and made me bigger than I’d ever been in my life, going to somehow push out my identity as an Artist and Art Therapist. Of course I knew this seemed ridiculous, but nonetheless it was a very real feeling. Going to work at my private practice provided a refuge from this scare process. I felt more grounded and quite fulfilled and whole working with my patients, while also being overly sensitive to what I perceived their reaction might be. I colluded with my patients(all of course on an unconscious and non verbal level) to keep my pregnancy out of the room as long as possible. I was more aware than ever of how much I enjoy and am fulfilled by being a therapist; suddenly having to leave this role even for about two months seemed very daunting and somewhat scary. At the time I was conscious of being overly concerned about my patient’s possible fragility with regard to abandonment, thus was focused on a few highly traumatized patients but everyone as well. I was also very aware that for me, holding on to my identity as an Artist and Art Therapust was essential to my managing my pregnancy. Being able to have a place where I could hide my pregnancy and ignore it was helpful as I went through the above described identity crisis.
For me, being an artist first and foremost, something that pregnancy and motherhood would never take away, definitely helped me through this crisis and sense of impending doom. Much of my anxiety also involved the thought, “What if all my patients leave me once they find out I’ve had the baby and I come back to an empty practice?” In one of the few books I found about this topic, I had read that some patients actually do that. They have a human need to know that you are ok and have had the baby and all is fine, and then they want to take control and turn the tables and they leave before you return. Some patients are actually afraid their therapist will be too different when she returns. There is a real concern about whether a new mother can really listen and give her attention to her patients. For patients who are not themselves mothers, how could they know that every new mother, no matter how attached to her growing infant, relishes having moments in her day to think about and attend to someone or something else. However, it is very true for some therapists that they return to work feeling very different as a new mother and do have a feeling of distance from their patients. This is a very complicated topic of course, so I will end on the note that in my posts, I try to describe my own experience and those of colleagues who have shared with me. Every therapist will experience this time differently, but for everyone, the fact that a big boundary has been broken is there. This will change the relationship between the pregnant therapist and all her patients. It can be a great opportunity for growth on both sides of the therapeutic process…

Sent from my iPhone

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