The Pregnant Therapist, Continued! Part 3: What Little Info Is Out There Still!

This is my third post on this topic. I am planning to put together some kind of workshop for therapists that will be about the very particular experiences in therapy for both therapist and patients regarding the pregnancy of the therapist. In my experience, there is very little preparation, actually maybe none, for the female therapist regarding how to manage the very unique experience of pregnancy, especially those experiencing it for the first time. In my personal experience, it was never discussed in my grad school program, although, actually, while I was in grad school, one of my classmates got pregnant and went to her internship during the beginning and middle of her pregnancy. She had her baby after we graduated, but I have some vague memories of her sharing some of her experience with us. At the time, pregnancy and babies were not in my radar or future plans, so I did not retain many memories of what her experience was like, besides that there was nothing in the curriculum about it, and besides one woman with teenage children, she was probably the only person in the class about to be a mom.

Anyway, I did find two helpful books that I read while pregnant. Both were not recently published. I don’t know where they are in my bookshelves, but I think they were the following two that I found on Amazon after a big search:

First one was published in 1994: The Therapist’s Pregnancy: Intrusion in the Analytic Space, by Sheri Fenster, Suzanne B. Phillips and Estelle R. G. Rapoport

The other one was: Awaiting the Therapist’s Baby: A Guide for Expectant Parent-Practitioners, by April E. Fallon and Virginia Brabender, published in 2002

A quick google search just now (2012!) did not produce much besides the first book mentioned and a short blog post on Psych Central: http://blogs.psychcentral.com/unplugged/2010/07/the-pregnant-therapist/

So this short post simply reveals that this is a very important topic for women therapists who are curious about the topic even if they are not sure they want a child, or thinking about becoming mothers, of actively trying to get pregnant, or pregnant right now and experiencing the “intrusion” in the “analytic space” or therapeutic space as I prefer to call it.

On the one hand, I am happy to have stumbled on a topic that is very relevant for therapists and patients of pregnant therapists, yet not a very popular topic that has been written about exhaustively. Seems like there is plenty to say about it, and not much that has been written since 2002, ten years ago! The first book which is probably more well known, is way out of date, as it was published almost twenty years ago!

In posting about this topic, I am curious to hear people’s experiences both as therapists and patients. In addition, since my pregnancy, I have worked with pregnant patients as well as patients who are thinking about having kids and for one reason or another know that I have been through it, and found that to be an interesting experience. I had one therapist patient who went through my pregnancy with me, came back after my maternity leave and then got pregnant and went through her pregnancy with me, leaving therapy to have her baby. I also have worked with patients who came to therapy due to the loss of miscarriage and seen some of them get pregnant and work with me through their pregnancy. I have also had patients who have gone through the experience of abortion and processed this experience with me, a whole different but very important topic as well, as it can be a lonely difficult experience in which the person needs a lot of support for various reasons, especially the often secrecy of this process, in which a woman often does not want her family to know and only tells a few people…

I have also since having my own child been a close witness to colleagues who have gotten pregnant and experienced the “before” and “after” of private practice, in which your caseload goes through a lot of upheaval in terms of patients who stay through your pregnancy and return after the birth, patients who leave in the midst of your pregnancy, and patients who stay up to your leave and then do not return. Of course, how a patient leaves therapy in the course of a pregnancy and birth can be very important, just as it is in general. Having someone process why they are leaving and terminate in a more healthy manner is very different from some abrupt terminations, and some that come with no communication whatsoever. By chance I had a few patients who were moving out of NY during the time when I was pregnant and left before I had the baby. The termination was the more natural kind with a lot of time to process the person’s leaving therapy due to moving and their feelings about leaving as well as feelings about “missing” the opportunity to work with me after the birth, which they were all curious and slightly sad about in addition to the other feelings around termination… One of my patients had been processing a lot about whether she wanted to be a mother or not and had a lot of ambivalence about it. She found it helpful to see me go through the pregnancy and share some of the experience with her before her move. She subsequently sent me a very nice package with a hand made gift for me and several baby gifts. In addition, she emailed me a couple of years later to share her announcement of her own pregnancy and the birth of her first baby. Of course this was especially meaningful and I was thankful to find out about her decision and happiness about becoming a mother…

So there are many aspects to this experience for both therapists and patients. I found it an odd synchronicity that for some odd reason, before my pregnancy in my private practice, I do not remember working with a mother although I may have had a few patients with kids that I forgot about; I do remember working with a father of teenage girls, with whom I did discuss parenting, especially the particular experience of being a father of teenage girls. I actually used my own experience as a teenager to reflect with him upon the particular challenges he was dealing with. Once I became a mother, I started working with more patients who were pregnant, trying to get pregnant as well as people who were already mothers.

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