“The Pregnant Therapist”--New York Times

Pregnant Therapist

On April 28th no less than 15 people emailed me Jessica Zucker’s article, "The pregnant therapist," from the New York Times. I am pregnant and I am a therapist, so it wasn't surprising.  I was thrilled to get this article and even more so that someone is opening up the conversation of what it means to be a pregnant therapist.

What Zucker states is true: no one writes about your therapist being pregnant and no one teaches you how to be a pregnant therapist. It's left out of the textbook. So we are left as practitioners and patients to create this process of talking about the pregnancy and it's impact on treatment.

I told my patients that I was pregnant in my fourth month. I did this to keep the relationship authentic. I wanted people to hear this from me before they noticed my body changing and started to wonder.

Honestly, it’s not all that interesting to talk about that I’m pregnant. It is what it is and my work with my patients isn't about me. Yet, it impacts our relationship. What I find that is interesting is that by saying I’m pregnant, and by going through the unavoidable experience of becoming more and more visibly pregnant, my patients are let in closer to me. There is an undeniable fact in the room with us. To ignore it would be bizarre. But what we would also be ignoring is the fact that, while our relationship isn't about me we do in fact have a relationship and the change in my body and the change in my life it represents have an impact on us. Through this we are forced to tear the wall down of me as a “blank slate” and for my patient to see me as another human who has movement in her life, too. Who must take time to consider together what the impact of that change will be on the therapeutic relationship.

This is about more than “How does that make you feel?” Instead we’ve had rich conversations. We've looked in new ways at boundaries--how they have existed in our relationship and what we want them to look like. How do we not tell too much but enough to help the relationship? There are questions I have declined to answer, and questions some patients don't care to ask. We've self-consciously created these conversations and worked to avoid defaulting to assumptions or norms. There's an opportunity here to look at how boundaries are constructed not just with me but with others in their lives.

Some patients aren't so interested in talking about it. Others are talking about their own pregnancies, or hoped-for pregnancies, their feelings about their bodies, becoming parents and their relationships with their parents. We have talked about the steps they need to find a relationship with someone they want to partner with to have children. We've looked in new ways at the significance of our relationship--what it means that I'll be on leave for a few months and what they want to be doing with their therapy. I've worked to make this experience an offering--letting folks know I'm open to allowing this experience to be an intentional part of our work. That breaks some rules--breaks the "blank slate" rule of therapy. I'm glad. We're breaking the rules together, intentionally.

I wonder what new conversation will take place as my maternity leave approaches, and after I return. I suspect I'll continue to share my experience, in ways that it adds value to my patients. We'll decide that together, as we've done in the pregnancy so far. I will offer this as an opportunity to help my patients construct this relationship and others in their lives. I know other therapists who've been nearly silent about their pregnancies--discussing only the administrative minimum.  I hope Jessica Zucker's article creates room for some new conversations.