Ambivalence towards boyfriend emerging as death wish against one's child

A young woman, mother of 9 month old baby, dreamt the following:

A am at a clinic or in hospital where I keep going to doctors asking what to do with my baby who is dead, but with whom I am still pregnant. They keep telling me that they can do nothing about it. And I keep imploring them that if she is dead what is the point of my carrying her. I am afraid I will  be pregnant with the dead baby forever.

The patient is new to me so I hesitated to jump to the conclusion that some kind of death wish towards the baby had manifested in the dream. More difficult than arriving at the deduction was the difficulty in deciding whether to communicate it to the patient or not lest it provokes serious negative transference. For it was her second or third session with me. So I asked her how old was the baby in the dream.

"The baby is same age as she is now."

"So how did the dream show your carrying, if she was already 9 months old?"

"I was carrying her like a kangaroo carries its young one in the pouch."

"So your baby was outside your womb in the pouch."

"No, it was inside. But I had like an extra flap of skin over my stomach, and I could hold that flap up to the light and see her shadow through it."

"That behavior of holding up the flap up to the light, it must have some point of contact with something else you did perhaps on the day of the dream?"

" No, I always do that. Whenever I need to examine something in depth, I take it to the lamp in that fashion and look for flaws in it. Its a habit. I do it all the time."

Now looking for flaws, especially doing it as a habit (ritual) is a component of obsessional neurosis. And behind all obsessional rituals lie death impulses and countermeasures to nullify them. The end behavior is a compromise formation between the two which makes no sense till you analyze it and often then the two opposite impulses can be seen clearly. So I took the chance of asking her if behind the dream element of her daughter being dead could it be possible that there was a wish for her to not to be alive. Perhaps at times you find her a burden to you.

"No she is not a burden to me. I love her very much. But I cannot say the same thing about her father.If there is anybody I wish dead, it is him."

So here was an indirect confirmation that there was an element of death wish in the dream though emerging against the father of the baby, perhaps because it was more acceptable. There was greater guilt associated with seeing her daughter dead and the unacceptable wish could rear its ugly head only while she was asleep and only as a dream.

"Why would you wish her father dead?"

"Because he is good for nothing.  Does not support her. Never comes around. I cannot stand him. Yes I want him dead. If he dies I can be free of the anger that the jerk is ignoring us like that."

"Was it an accidental baby? And did you know her father when you got pregnant by him?"

"Oh I knew him very well. For 2 years. And it was planned. In fact to get pregnant I had my IUD removed."

"Why would you want to have a baby from someone you wish dead?"

"He was not like that when I knew him. But the minute he heard I was pregnant, he took off. And has never come back."

"Did it affect your attitude towards your pregnancy?"

"Did it! I could not make up my mind about abortion. I almost went for abortion at the first, the second and the third month. Even during the baby shower I was thinking of giving her up for adoption."

"Why was that?"

"For the baby has brought me so much trouble. I almost died when I was 4 months pregnant from profuse bleeding. She ruined my health. I developed heart condition and diabetes. Added weight. Thank God my diabetes is gone. But the problem with my heart valve remains."

"So you have reasons for wishing for her to have never been born. For only if she was not born you would not have had these complications."

"Yes, but at the same time I cannot imagine ever parting with her."

"No wonder the dream shows her dead and yet at the same time as a part of you forever."

There perhaps was another wish behind of making the baby a part of her forever - as a compensation for lack of penis. A wish that has to come to an end with the delivery and which is the central issue behind post-partum depression. But the patient was certainly not ready to explore this aspect of herself, and no attempt was made to do so either.