Client Reactions to Pregnancy as Processed by this Therapist

The therapeutic alliance created between therapist and client, when done effectively, is a space that our clients embrace and cherish.  So, what happens when the therapist is pregnant?  In my professional experience I worked with children, adolescents, and their families who are in residential care.  What’s special and challenging about residential care is that one is put into a parental role/vantage point more so than in other forms of treatment.  Therefore, I pondered how my kids [clients] reacted to my pregnancy.

The unspoken rule to disclose a pregnancy is to wait until the end of the first trimester.  During my pregnancy I had changed positions from managing an 11-15 year old girls dormitory to managing a dormitory of students ranging in ages of 16-19 whose focus was on transitioning from high school.  It was best to wait in sharing this news mainly to avoid throwing too much change at the students and their families – the change in position and the pregnancy.  Although I found this to be the right choice, it created a position that felt unnatural.  I am a believer that transparency, when appropriate, is a very important part of therapy. 

It felt abnormal having to keep such an important aspect of my life from my students.  Don’t get me wrong, I didn’t go around offering information about by daily life, but I was nauseous, tired, gassy, and forgetful.  When my students would question the change in my behavior or get frustrated with me, I felt like I was trapped and unable to provide understanding on why I am not acting like my usual self.  The longer I held in the information the more my imagination ran wild in regards to my students’ reactions. Concealing my pregnancy grew more challenging when I started to show, meaning my baby bump started to become more prominent.

The announcement that I was pregnant weighed heavy on my mind. The announcement could convey many things such as “You (the client/student) are not the center of my life”; “I go through life changes too”; and the most anxiety provoking “I had sex”.  Once I made the announcement I found that the initial reaction to my pregnancy from my students fit into three categories: excitement, indifference, and “What about me?”

My students had concerns around who would cover my work responsibilities. Through further self-reflection I realized for so long I had been “taking care” of these students and they are trying to find their new consistent.  Perhaps this was their way of starting to disconnect their relationship with me because they believed I would leave once my baby was born.

At the time of my pregnancy I had been at my agency for over five years.  I had seen many generations of students and been in different roles.  Working in a residential facility allowed for a level of connection that’s different from other forms of treatment.  There is the constant therapeutic interactions with the client in their living space.  This is different than home visits or outpatient because intervention and relationship building is happening on a daily basis. 

There were some comments from students that were startling.   I experienced hearing hurtful comments, but to have them directed at an innocent human who has not entered this world was overwhelming.  Through self-reflection I’ve deduced that much of this had to do with the student managing my approaching maternity leave; processing their familial relationships; having to manage the idea that that there was someone other than them I am going to care for. 

In the midst of this life changing event I was forced to acknowledge my role, the impact it will have on students, and it was no longer about just me but “us”.  The relationship changed from “us” being them and me to “us” being them, my unborn baby, and myself. 

To be honest I think for some of my clients it was a lovely addition.  They were given a back stage pass, in a sense, into a very personal realm of my life.  Prior to pregnancy, sharing my therapeutic relatiohsip  was not something that was difficult. I was able to be in the moment while holding onto my emotions and awkward silences with ease.  However, many times I felt I was pulled in various directions juggling the needs of my students, myself, my baby, and my husband.  It wasn’t until I got pregnant that I realized I was not the best at taking care of myself.  However, when you are carrying a child you have to slow down and take care of yourself.

There were so many times when I felt I had nothing else to give, that I was running on fumes.  To use yourself to promote change in others is exhausting.  To nurture and support someone else is exhausting, and in all honesty teenagers are exhausting.  So having to hear about how “You are unfair” or “horrible” and “You need to get your hormones under control” was infuriating because to keep my hormonal rages under control while at work took everything within me.  In those moments when I had nothing to give I wanted my students to demonstrate the empathy and patience that had bestowed on them time and time again, but I couldn’t ask that of them because this is a therapeutic relationship it’s not about them meeting my needs.

I thought about my baby all the time.  It ranged from thinking about the possible bodily functions that could occur while working with a student to my baby physically adjusting herself while in utero.  

I believe the hardest part about being a pregnant therapist was the changes I was experiencing and the vulnerability that came with when working with my clients. For example, exposing my impending motherhood, losing my slim figure, and letting the world know that I’m a sexual being.  Being vulnerable is hard and having to do so in front of my students was a learning experience I’ll never forget.

I wrote this article 9 years ago for a former colleague’s newsletter. Since then I changed jobs, moved to another state, and had two more kids. I got a lot more experience with being a pregnant therapist. I wish I could say it got easier or that I mastered being able to balance pregnancy and my role as a therapist. Somethings got easier while other things got harder. Talking about my pregnancy with my clients became easier, managing pregnancy symptoms well… that continued to be a challenge. Once I threw up in my office, while in session with my client, and his family. Pregnancy is just one example of the life events we experience that can also influence the work we do. Now this doesn’t have to be a bad thing, in fact if we are self-aware and able to effectively manage the emotions that come up during life events it could increase our empathy for those we serve. Sometimes our life follows us into the therapy session, as therapists we have to know how to effectively manage this so that we can provide a level of care that allow our clients to feel supported and understood.

I appreciate you taking the time to read this post, as I’m just trying to offer a few words of wisdom in a complex world. I hope you found it helpful or maybe you are already doing all of what I suggested, and it just feels good to feel affirmed. Parenting is hard and I am here to help. I offer parenting support services to help you in this journey called parenthood. If you would like to set up a time to chat my contact information is below.

Jennifer Bailey, LCSW & RDT

jbaileytherapyservices@gmail.com

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