This paper explores challenges in the treatment of women suffering from disturbances in maternal identification. A review of
the psychoanalytic and developmental literature focuses on the frequent finding of early-onset mother–daughter relational
disturbance involving maternal narcissistic fragility and exaggerated dependency needs, intergenerational trauma, and
related psychopathology including mutual affect dysregulation. A case example of a young woman with a severe anxiety
disorder is presented and discussed to illustrate the challenges to the traditional psychoanalytic technique. This patient
avoided pregnancy into her late thirties and entered analysis with feelings of inauthenticity, characterological masochism,
and a “secret mission” to unmask the witch recurring in her dreams. Through an elaborate working-through of negative
maternal transference, the analyst and patient saw through the birth of the patient’s authentic self, a new approach to her
career, her relationships with men, and her anticipation of the birth of a child by the sixth year of treatment. The author
posits that psychoanalytic technique benefits from contemporary, attachment, and trauma research that supports the
analyst’s playing a more active role in approaching, co-regulating, tolerating, and integrating avoided affects and memory
traces that are associated with early-onset relational disturbances worsened by the effects of violence, maltreatment, and loss.