Managing Countertransference in Psychotherapy for Pregnancy Loss

Abstract

Abstract This chapter begins with a brief theoretical and empirical review of various aspects of countertransference, particularly countertransference management and its relation to psychotherapy outcome. Evidence-based relationship principles derived from research on countertransference in psychotherapy are then applied to the treatment of clients who have suffered a pregnancy loss specifically. Pregnancy loss with and without infertility are examined in this chapter because both represent reproductive traumas that can have a significant impact on an individual’s sense of self and other, which, in turn, can cause powerful transference–countertransference dynamics in the therapy relationship. Based on theory and research, signs of internal countertransference reactions and overt countertransference behaviors are explored, including inappropriate therapist self-disclosure. Common transference–countertransference themes when working with pregnancy loss and infertility are discussed, including when either the therapist or client becomes pregnant. Case examples demonstrate the application of these ideas. Clinical challenges to managing countertransference and clinical implications are offered.