Psychotherapy for Pregnancy Loss

Abstract This book applies cutting-edge research on the therapist–client relationship to psychotherapy for pregnancy loss in a way that is easy for clinicians to apply in various settings. Specifically, it takes relationship elements found to predict treatment outcomes (i.e., evidence-based relationships and responsiveness), such as alliance, empathy, emotional expression, alliance rupture/repair, countertransference management, and therapist responsiveness to client attachment style, and, through in-depth clinical illustrations and practical relational guidance, demonstrates how they can be used to help clients affected by pregnancy loss to (a) process and grow from the trauma of loss, (b) restore healthy self-esteem that was assaulted by the loss of a pregnancy, and (c) rewire insecure attachment internal working models to more secure. Though pregnancy loss, including miscarriage, stillbirth, recurrent pregnancy loss, pregnancies after loss, ectopic pregnancies, and fetal terminations due to genetic anomalies, which sometimes occurs within the context of infertility, is a relatively common event that often has long-term and severe psychological consequences for individuals and couples, little clinical guidance exists for psychotherapists working with this client population. Similarly, though decades of research on the therapy relationship supports its association to treatment outcome, less clinical guidance exists on how exactly practicing clinicians can apply relationship research to the clinical context with specific client populations. Using the theories of attachment and of the psychological experience of pregnancy loss as a guide, this book argues that the therapy relationship is especially important in psychotherapy for pregnancy loss.