Pregnancy may stir intense feelings in clients. This may result partially from their feeling intense rivalry with the newly important being coming into their therapist’s life, and also from viewing their therapist as a sexual being. Observing their visibly pregnant therapist may be the first time clients have even considered that their therapist has a life outside the consulting room!
Such reactions may serve as a catalyst for change in treatment, perhaps helping the clients resolve issues of loss, sibling rivalry or oedipal conflict (Cullen-Drill, 1994). Further, the reactions may engender discussions regarding the length and course of treatment and perhaps motivate clients to maximize their time in treatment.
However, emotional changes in the therapist herself due to hormonal fluctuations of pregnancy, fatigue and a growing sense of vulnerability may reduce her functioning as a therapist. Impending parenthood may also cause emotional changes for male therapists, that could become problematic if left unaddressed (Guy, 1986).
It may be important that the psychologist enter her own psychotherapeutic treatment during this time so that she is able to distinguish her unresolved issues from those of her client. (This may similarly be the case for male therapists who are soon to become fathers.) Objectivity can be difficult to maintain during the heightened sensitivity of pregnancy. Regular supervisory sessions or peer consultation can also be helpful in identifying personal issues and maintaining appropriate boundaries within the therapeutic session.
Special challenges in interacting with clients might include:
Personality-disordered patients who may vacillate between hostile and affectionate attitudes toward the pregnancy.
Male patients who reveal sexual fantasies involving their female therapist.
Female clients with a miscarriage history may experience renewed feelings of loss when the therapist reaches the gestational stage at which the client lost a pregnancy.
Jealous patients who view an anticipated maternity leave as abandonment.