Transference or Not? Client Response to Therapist Pregnancy

Not so another pregnant client. Joan was upset that her pregnancy hadn’t been planned. She was anxious about changes in her relationship with her husband and angry about the interruption in her career plans. Being in the room with an obviously pregnant therapist made it difficult for her to avoid talking about her own issues.

Fortunately, we were able to make constructive use of it but I would not have been surprised if she requested a transfer or terminated.

Mothers:  Clients who are about the same age and happy as mothers may feel they have something new in common with you and be eager to chat about it. Those who find mothering difficult may share their complaints and warnings.

Older mothers may want to give you parenting advice. It’s all potential therapeutic material. Or not. I did my best to take the client’s lead about whether they just wanted to make some passing comments or whether they were introducing new material that would lead them to better self-understanding about dysfunctional patterns.

Jennifer was a poster child for transference issues. Her mother hadn’t liked being a mother and she didn’t either. Sometimes I found myself thrown into the role of disapproving and critical mother, sometimes into the role of her teen daughter who often let her know that she was a failure as a mom. Sensitive and smart, Jennifer was able to understand and work on the issues.

She took a recess during my month long leave. She came back to treatment to continue to work on being a different kind of mother for her daughter than she herself had had.

Contrast that with Kelly, a client I was treating when I was pregnant with child number four. Also a mother of four, she’d often start a session with a few minutes of friendly advice about the care and feeding of a big gang.

Then she’d return to working on the goals of her therapy. When asked what the advice-giving was about, she simply stated that sharing tips that can make life a little easier is just what women do for each other.

Caretakers:  Some clients will see you as fragile and vulnerable. They want to engage in caretaking, asking how you are feeling, bringing you little presents, or offering to do things to make you more comfortable during sessions. Sometimes it’s an example of “transference” but not always.  Sometimes the solicitousness is simply an expression of caring.

I’d been working with a Mike intermittently for a number of years while he dealt with his teenaged son’s drug habit. His expressions of support and caring while I was pregnant were not neurotic or born of anxiety. They were not an effort to do for me what he couldn’t do for his son. He was acting on his belief that men should not absent themselves from the cycle of life. He’d offer to do something for me (like get a glass of water), then get on with the goals of his therapy.

In contrast, Linda felt it would be unfair of her or even dangerous if she were to be intensely emotional around me. “How can I get angry when I might upset you?” she asked. “I don’t want to be the reason you miscarry.”

Further discussion helped us make sense of that idea. She had grown up with a mother who regularly warned her kids that any angry voices would give her a heart attack.  Her transfer of old fears and concern to me led to some important therapeutic work.

Client Responses Will Be As Unique As They Are

Few graduate programs include a class or two in how to manage our clients’ responses to what is a common event in female therapists’ lives, our pregnancies. I found few studies that are helpful.

The male supervisor who had always been a wonderful resource for me about other issues couldn’t seem to relate to this one. Neither could my male office mate. My best information and support came from two wise older women therapists who were also mothers of multiple children.

“Your pregnancy may be the most important thing happening to you at this time but it isn’t necessarily so for your clients,” they said. “Consider each person in their uniqueness.” Good advice.

Pregnant career woman photo available from Shutterstock

Transference or Not? Client Response to Therapist Pregnancy

Marie Hartwell-Walker, EdD

Marie Hartwell-Walker, Ed.D. is an author, licensed psychologist, and a marriage and family therapist who has been in practice for more than 35 years. She is a regular contributor to Psych Central and one of the therapists who answer questions at Ask the Therapist.


APA Reference
Hartwell-Walker, M. (2016). Transference or Not? Client Response to Therapist Pregnancy. Psych Central. Retrieved on August 10, 2020, from


Scientifically Reviewed
Last updated: 17 Apr 2016
Last reviewed: By John M. Grohol, Psy.D. on 17 Apr 2016
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