The Therapist's Pregnancy in Combined Individual and Group Therapy: A Catalyst for Exploring the Tyranny of Motherhood

Abstract: Relational psychoanalysis increasingly recognizes that the therapist's subjectivity significantly influences the therapeutic process and, on many occasions, facilitates therapeutic progress. The therapist's pregnancy, in particular, may be regarded as a vivid expression of her subjectivity in the clinical room and can yield both disruptive and facilitative effects for her patients. Mothers often become recipients of omnipotent projections and expectations of endless support when they meet others' needs, while simultaneously being represented as insensitive or depriving—receiving envy—when they fail to meet those needs. Comparable transference–countertransference dynamics may operate in the therapist–patient relationship. This article endeavors to (a) provide insight into the impact of the therapist's pregnancy in the clinical setting of combined individual and group therapy, (b) delineate the mutual vulnerability of female therapists and patients in their intersubjective interactions around themes of mothering, (c) support the benefits of combining individual and group therapy, and (d) emphasize the importance of a strong bond between cofacilitators in relationally oriented group psychotherapy, especially in managing "tyrannical" projections and existential anxieties that surface in such challenging therapeutic processes. Core transference–countertransference themes that emerged include anxiety, hostility, envy, identification, dependency, fear of abandonment, separation, and sibling rivalry. Similar transferential reactions have been found in other studies.