My psychotherapist is pregnant: can I continue therapy?

Psychotherapy in our country is a young and predominantly female profession. It is not surprising that the creation of a family by the therapist, the bearing and birth of children, increasingly becomes the background of psychotherapeutic relationships. A backdrop that raises a number of ethical questions. When and how to communicate this to customers? At what point do you go on maternity leave? And how to behave during these months?

“Waiting for a child is a unique situation, because it is almost the only state that cannot be left outside the office door,” says psychologist Inga Green. — The client literally accompanies the therapist’s pregnancy with his eyes, and it can cause a range of reactions in him — from joy, surprise and curiosity to sadness, envy, disappointment and anger. All this is normal and important for work.

What are these reactions?

Belly like a mirror

Now the sessions hear topics that were previously postponed “for later”. For example, parenthood.

“A growing belly literally pushes this topic into the counseling process, forcing the client to express his attitude, to answer: do I want children or not? — says Inga Green. — You can’t avoid the topic of sexuality, because the child somehow got into this stomach. The client may be literally bombarded with fantasies about the therapist’s sexuality. It can be especially hard to deal with a therapist’s pregnancy for women who have experienced their own maternal loss.

In addition, the experiences associated with early relationships are exacerbated, the traumatic experience of one’s own childhood is raised. One of the forms of its manifestation is jealousy, because «my therapist will now have a real child instead of me.» Perhaps the unconscious is seldom so close to its discovery through fantasies, dreams and experiences, as at this time.

The realization of the fact that the psychologist outside the office has his own life, which will stop the process of therapy for a long time, can cause painful experiences, provoke a feeling of abandonment, rejection, a crisis of confidence.

All these reactions are normal and natural, it is important to “bring” them into therapy and discuss them with your therapist. Resuming therapy after maternity leave can also cause different feelings. If the therapist returns to his office just a week after the birth, other kinds of worries are not excluded: how can this person take care of me if he is ready to leave his baby for work?

When pause is not enough

For some, the therapist’s message about the pregnancy and the planned pause in therapy may turn out to be such a difficult and unbearable situation that the resentment, anger, rage, accusations that the client makes against the therapist cannot be reflected and understood. In such cases, it is necessary to stop the therapeutic process before the planned pause.

This is important to do for two reasons.

The first is by presenting his anger in the office, the client then finds himself outside alone with auto-aggression, guilt and shame for his feelings. This is devastating to him and must be stopped as soon as possible.

The second reason has to do with the fact that dealing with the client’s ongoing anger can affect the therapist’s well-being.

“No matter how trained, competent, with personal therapy and excellent supervisors, it is impossible to say to your own stomach – “this is part of my job, it should be so,” says Inga Green. “The therapist is especially vulnerable at this time, and in order to avoid complications and, in the most critical case, the loss of a child, he must take a break.”

The American Psychological Association (APA), which makes the highest ethical demands on therapists, reminds us how important it is for women to take care of themselves during this time, find time for naps and snacks, and give up self-blame when going on maternity leave.

fruitful time

The pregnancy of a psychologist is an unusually productive time for psychotherapeutic work. Even if the topic does not become a subject for conversation, it pulls out some fantasies, thoughts, sensations like a hook, allows many problems to be discovered and brought to therapy.

“During my pregnancy, the first thing that came up was the attitude of clients to their own reproductive choice,” says Inga Green. — For those who would like to become a father / mother, but doubted, feared or procrastinated because they did not feel confident in the future, the therapist becomes the one who paves the way.

And for those who have chosen not to have a parenting experience, this situation provides an opportunity to discuss their decision and receive approval and support: «My therapist is pregnant, but she does not pull me into this story, she testifies and supports my own choice.» Sometimes it turns out to be a very valuable support.”

“Remind the client that you are ready to discuss any of his feelings”

Inga Green, Counseling Psychologist, Family and Marriage Psychotherapist

When to report. At least a month before your departure, preferably before the belly becomes visible, but not too early, as pregnancy is especially vulnerable before the 12th week. In the event of a loss, we involve clients in mourning and provoke fantasies about its causes. The optimal message time for each of the clients can be discussed at the supervision.

How to do it. Wait for stability within yourself. Do not communicate to all clients in one day or within one week — give yourself time to experience this message with each client with attention and care.

Communicate the pregnancy clearly and unambiguously, in a simple way, at the beginning or in the middle of the session, so that the client has the opportunity to react, and you have the opportunity to support him and normalize his feelings. It is immediately necessary to specify the prospects for work and clearly orient the client what options you offer during your maternity leave.

Seek support. The therapist may need not only weekly supervision, but also the support of the intervisor group. By the way, male therapists who are preparing to become fathers also become especially sensitive and fragile at this time, they need support. It is often important to resume personal therapy during pregnancy and after childbirth.

Focus on your well-being. Someone pauses in work even before conception, and someone is ready to go to the maternity hospital practically “from the office”. Both methods have the right to life, their pros and cons. It is important to weigh your risks against how customers might react to each choice.

Discuss everything. You need to remind the client over and over again that you are ready to discuss any of his feelings about your pregnancy. Some clients may feel worse because therapy has a deadline.

And someone, on the contrary, has a greater openness — as if some barrier has collapsed between him and the therapist. If before the client perceived the psychologist as a functional figure, immortal and invulnerable, now he understands that he is dealing with a living person, a woman. And it is unexpectedly liberating and liberating.

Be prepared for imperfection. It is very difficult to do everything perfectly because your pregnancy conflicts with the needs of the clients. In this place, mistakes, disappointments and strong feelings are inevitable, the recognition of which makes your work more valuable. If a client takes care of himself and decides to leave you for another therapist, interrupting therapy is his choice and right. Just as it is your right to take care of yourself and the child you are carrying.