The psychological nature of female psychogenic infertility: psychoanalytic reflections

Mordas Ekaterina Sergeevna PhD in Psychology Associate Professor at Moscow Institute of Psychoanalysis 121170, Russia, g. Moscow, ul. Kutuzovskii Prospekt, d.34, str.14 morkaty@yandex.ru Other publications by this author

Introduction

This article is presented as reflections on the phenomenon of psychogenic infertility in female development. The article summarizes the theoretical ideas and shows the results of some of our studies (analysis of individual cases (case study) and interpretation of the obtained material) devoted to the problem of female psychogenic infertility in a psychoanalytic approach. The work includes observations from clinical practice. Special attention is paid to such aspects as the image of the mother and psychogenic infertility, destructiveness and perversion, denial of femininity and impaired identification with the maternal figure, transgenerational transmission of conflicts in psychogenic infertility. 

The psychological nature of female psychogenic infertility

The reproductive system acts as a means of expressing unconscious conflicts related to femininity, motherhood and, in general, female identity. Parents (primary object relations), ancestors (transgenerational transfers), and space (cultural, social) play an important role in human development. The history of a person's life and experiences is reflected in the body (the reproductive system in particular, since in this case we are talking about women with psychogenic infertility). The body is the "stage" on which the early drama of the history of relationships is played out, where the observed inner and outer reality of a woman becomes apparent....

The image of the mother. The first object with whom the child meets is the mother, in the process of development this object is introjected and becomes an internal object. Thus, the projected maternal image acts for the daughter for life as a model with which she identifies and differentiates herself from (D. Pines). In order for a person to differentiate himself and further separate himself, a fairly successful experience of symbiotic relationships is necessary for this. From the description of women with psychogenic infertility, we will see that this experience is often not lived. There are fixations at the oral and anal stages of psychosexual development and the inability to separate from the mother.

In the process of development, a person acquires the image of a mother – a good or bad image of a mother. It is desirable that this image be both good and bad at the same time – this will speak about the integrity of the personality. D. Pines wrote in detail about the good / bad image of a mother, about accepting and living through pregnancy. With a good image, a woman identifies with her mother, has the ability and ability to bear and give birth to a child. With a bad image, there is a possibility that the fetus will be expelled from the mother's womb.

It so happens that the experiences of life (the mother seduces to life, invests libido, containers) and death (kills, destroys) the child are associated with the maternal figure (the primary experience of relationships). And in general, we come to the idea that the mother is like fate.

Pregnancy is like a rebirth of the experience of oneself as a child. During pregnancy, a woman narcissistically identifies with her fetus, and this revives her infantile fantasies of herself as a child in the mother's body. This can lead to the resumption of intense ambivalent feelings towards this mother, to an internalized representation of her and herself as a child. If the hostility is too great (there is hostility in ambivalence), then the woman may feel her inability to allow the real child inside her to live. And then such incapacities as infertility, expulsion of the child, the desire to kill the "mother" (meaning the inner mother, or unwillingness to restore a previously destroyed object, recalling M. Klein), fear that a poisonous creature will appear or develop inside (fantasies about a mortifying fetus), the child is perceived as a threatening and haunting object (about such an object M. Langer wrote in her work on psychogenic infertility, envy and hatred of a woman for a fertile mother). The author also wrote that even if a psychologically infertile woman physically becomes pregnant, then persistent anxieties are actualized and intensified (the child is experienced as evil, bad, persecuted), which contributes to the expulsion of the child. In other words, there is a miscarriage or a frozen pregnancy. ^[8]

Representations of the mother and the mother-child relationship in the context of destructiveness.. J. Reinhold in his work "Mother, anxiety, death" describes the basic anxiety that appears in a child due to the mother's internal hostile feelings towards the child.^[7]

J. Reinhold writes that already in the prenatal period the child feels hostility. Experiencing the experience of hostile feelings forms a Reinhold death complex in a child. At the present stage of the development of psychoanalytic thought, ideas about infanticide and the fantasy of infanticide will sound. In any case, the death complex manifests itself before pregnancy and during pregnancy of a woman (these may be complications during pregnancy, fantasies that the child is like some kind of foreign body that interferes, destroys, entails death and which is dangerous, that is, can kill a woman).

Pierre Olanier notes that the desire for death (in this case, we can turn to the ideas of transgenerational transfers) in relation to a child turns the latter into a murderer of the child who will be born to him when he in turn becomes a parent: thus, obeying the desire of his parents, he destroys his own childhood… The unwillingness to have a child leads to the appearance of an infanticide phantasm and the desire to make this phantasm a reality (U. Maidi). ^[1] A little later we will return to the results of the study of the transgenerational transmission of conflicts in women with psychogenic infertility.

One of the aspects that comes to light in the study of the life history of women suffering from psychogenic infertility is neurotic inversion: an active phallic mother and a passive absent father. ^[4] In this case, male sexuality will be attributed to a woman (F. Dolto). An internal conflict of femininity and masculinity is likely. Masculinity prevails over femininity. Often such women succeed in the social sphere, they manage to build a career and be quite successful in business. Children can be thought about when the menopause is approaching – the time when the process of childbearing will be irreversible and menopause is experienced as castration. Initially, the child fantasizes and then there is the possibility of his birth. If you ask such a woman to introduce a child, we can hear in response: "what, what, an ordinary child . . . ., arms, legs, head" or "I see myself and a crib or stroller, but I don't see the child himself" or refuse to imagine (with repressed pain in this regard). Such women experience castration fear, are active, and femininity is suppressed.

Gender role identity in women with psychogenic infertility is built according to the masculine type (according to the results of our studies, voiced and published earlier). ^[4] At the same time, fathers can be experienced as safer than the mother.

In this regard, the mother can be experienced as dangerous? The mother can act as an absorbing and castrating figure. Initially, in the development of a child at the anal stage of development, it is such. The so-called phallic mother, who possesses all the attributes of power and wealth and establishes the "rules of life" and prohibits satisfying desires in the desired way (we are talking primarily about the anal stage of development and toilet training). In this regard, such an image of a mother can cause fear and feelings of inability to separate from her (especially if the real mother holds the child close to her and does not let him go). In relation to a girl, such a mother may not seem to give her daughter permission to become a mother herself (depriving her daughter of her desire). And in this case, we can consider infertility as "castration", as the lack of internal permission to become like a mother and be different from the mother (where pregnancy = separation according to D. Pines). The inner mother deprives the daughter of the opportunity to become like her, that is, a mother, to realize her reproductive function and enter a new stage of psychosexual development, if we proceed from the idea that pregnancy and motherhood as a stage of psychosexual development (that is, here we can also turn to the topic of symbiosis in a mother-daughter relationship).

Denial of femininity, motherhood. Most psychoanalytic works with the representation of the case begin and end with the idea that women with psychogenic infertility deny and do not accept their femininity. And at the end of the psychoanalysis, having accepted her femininity, the woman became pregnant. That is, women suffering from psychogenic infertility are experiencing a conflict related to the acceptance of their femininity (we already noted this a little earlier in a slightly different context).

It is the mother, as a maternal object, who consciously or unconsciously attributes the child to the physical sex and a certain gender (D. Winnicott). Integration of the masculine and feminine parts: femininity is present in the first relationship with the mother. If the maternal figure is weakened, femininity cannot take place, the child cannot afford to provide a "sufficiently satisfactory" narcissistic place that allows him not only not to be afraid of separation, but also to build a masculine component of mental life" (W. Maidi) ^[1]. Women suffering from psychogenic infertility have a false femininity based not on identification with their mother, but on the basis of primitive imitation of her. Because identification with the "dead mother" that is contained in their representation is impossible.

In the history of the development of such women, oral frustrations or severe trauma in the first early object relationships are noted, primarily postpartum depression of the mother = the phenomenon of the dead mother. ^[4] The girl experiences an early experience of losing a good object - there is no experience of grieving - grief "freezes" - the image of the mother remains split - identifies with a bad/dead mother – the child is endowed with terrible, evil and bad features - difficulties of identification with a good mother: thus, one can imagine how a woman's experiences unfold. It should be noted here that if the idea was previously voiced that women with psychogenic infertility have difficulty identifying themselves with their mother, then it should be clarified that such women identify themselves with their mother, but not with the image of a fertile/good mother giving life, but identify themselves with the image of a dead mother.

Additionally, from the analysis of stories: tragic events related to motherhood (loss of mother, birth of sibling). Traumas in the life story of a sense of loss, since both the father and mother remain emotionally inaccessible to the girl; alcoholism and later the death of the father; infidelity of parents to each other; manifestation of physical violence in the family, parental divorce, parentification, "dead mother", "dead father", transgenerational transmission of conflicts "crypts and ghosts", untreated traumatization and unlived grief. ^[4] Thus, the leading events in the life history of women suffering from psychogenic infertility are violence and the experience of loss not experienced.

Violation of identification with the maternal figure: in its creative function (motherhood = creative ability). The conflict of ambivalence. Separation in this case = "mother's death". The impossibility of separation from matter/symbiotic relationships: J. Mitchell, in connection with modern changes in family configurations, describes such a phenomenon as a vaginal man (a vaginal man demonstrates a return to the original relationship model when the infant merged with the mother, and the father was mentally absent.) and a vaginal woman. And it raises the question – can there be people of this type, speaking of a man, to be fathers and accept women as mothers of their children in a mental, not biological sense? In relation to a vaginal woman, such a woman identified herself with her mother, but she failed to internalize femininity or perhaps "motherhood", that is, she could not give them meaning.  A vaginal man and a vaginal woman can be a man and a woman, but he or she cannot physically become a father or mother, since both are identified with the child. If we turn to the conclusions of J. Bowlby, it can be said that a vaginal woman or man has not mourned the loss of either her infantile mother or her infantile Self.^[2]

Incestuous representations in infertility (M. Bilovsky). Unconscious incestuous representations during pregnancy can be a factor in infertility. H. Deutsch noted that the first child in a woman's life is a child from her father. In this regard, the child may be experienced as sinful. And psychogenic infertility can act as an opportunity to avoid this "sin", which sounds in the works of K.D. Dali and K. Horney about menstruation – when a woman rejoices at the onset of menstruation, thus, as if rejoicing that "sin did not happen."

Transgenerational transmission: psychogenic infertility. Unconscious maternal conflicts are part of the traumatic experience and are passed on from mother to daughter over several generations.  Suppose that maternal conflicts underlie the impossibility of identifying a girl with a maternal figure, since the maternal image is experienced by the daughter as negative and ambivalent (negative transfer to the mother due to her own hostility towards her). And as a result: the lines of psychosexual development, libido development (fixation at the oral-anal stage of development), object relations in girls (according to the type of symbiotic relationships) are violated. As a result, a specific personality of a woman who has difficulty getting pregnant (unable to get pregnant) is formed. ^[3]

In this regard, we conducted a psychoanalytic study of transgenerational conflict transmission in five women (35-44 years old) suffering from psychogenic infertility. The study was conducted in 2021. The following methods were used in the study: Metapsychological assessment of the personality of an adult (A.Freud, W. Nagera, W.E.Freud); The scheme of the primary interview (Balint, 1961); An interview about the attachment of J. Bowlby for adults; genosociogram.

The following results were obtained: all women had impaired object relationships. In the first case, we note the lack of the ability to create a family due to the severe traumatization of early object relations, parental divorce, reliable internal parental introjects have not been formed, the presence of internal conflict, intergenerational trauma and transgenerational transmission of conflicts associated with the deportation of ancestors, extreme poverty and hunger, parentification is present in history.

In the second case, unreliable internal parental introjects, violated identifications, parental divorce, impaired function of the paternal object, trauma after rape, emotional inaccessibility of the "deadness" of the mother, immature identity, transgenerational transmission of conflicts has a recurring pattern in several families of the respondent, siblings also lack fertility in one line of offspring, intergenerational transmission of stories It is retold under the prism of magical influence on the fate of descendants, a dispute over inheritance, "unpaid bills".  Intergenerational conflicts are "anti-mother". The first two cases are presented as primary infertility.

In the third case, the "anti-mother" transgenerational conflict was revealed (the woman suffers from secondary infertility). Reliable internal parental introjects have also not been formed, the emotional inaccessibility of the mother "dead" mother", "anti-mother" has been revealed. Identification with a mother performing abortions, killing a fetus, transgenerational transmission of injuries is associated with the role of a "substitute child", "anniversary syndrome", repeated abortions and miscarriages.

In the fourth case, identifications are violated, violations of child-parent relations are traced – severe exploitation of child labor, emotional inaccessibility of the "dead mother", "dead father", transgenerational transmission of conflicts "crypts and ghosts", the syndrome of injustice of fate, "unpaid bills", a dispute over inheritance, the patient has secondary infertility.

In the fifth case, unreliable internal parental introjects, violated identification, "dead mother" with the mother, violations of child-parent relations, impaired function of the paternal object "dead father", transgenerational transmission of injuries "anniversary syndrome", "survivor syndrome", "parentification", secondary infertility are also traced. 

All five women have an unreliable type of attachment. In the first case, promiscuous sociability. (Socially Promiscuous), an adhesive relationship ("clinging") to an unstable partner is similar to a relationship with a "dead father". In the second case, "ambivalent insecure attachment" or "anxious insecure attachment" with a vivid angry reaction to separation, resistance to contact with an object when meeting. In the third case, a violation of attachment with a change of roles. (Role - Reversed Attachment Disorder), taking on the parental role and responsibility, the child-parent relationship is inverted, over-caring. In the fourth case, Inhibited Attachment Disorder. Unwillingness to approach, touch or manipulate inanimate objects, with compulsive Compliance, readily agrees with the instructions of the object, has a limited affective exchange. In the fifth case, inhibited Attachment Disorder, avoidance, withdrawal from communication. Frightened, intimacy of attachment is alarming, separation with resistance, fear with severe distress, with compulsive Compliance, consent to submission with the instructions of the attachment figure. Within the framework of the mental organization of all five women, there is aggression, denial, splitting, directed primarily at oneself; obviously a strict and controlling Super-Ego with a relatively weak and deficient Ego.  All five women have violations of child-parent relations, emotional inaccessibility of the mother, impaired function of the paternal object, unconsciously ambivalent attitude to pregnancy and motherhood, confused immature identity. All five women had identified traumas such as "mother's deadness", "father's deadness", "parentification" that are not recognized and integrated by women, untreated traumatization and unlived grief.

Let's turn to the ideas of Marianne Leisinger-Boleber, where infertility is an expression of an unconscious desire for death, identification with the "dead" body of the mother, as prevention of merging with an object during intimacy, fear of close relationships. ^[9]

In describing the clinical cases of using the method, the author proves how working through the interpretation of the myth of Medea with patients changed their experience of femininity and allowed them to become pregnant. It can be assumed that the unconscious fantasy of Medea is generated by the following factors: early sexual fantasies, repressed memories of object-relational traumas, for example, postpartum depression and the ability to experience bodily desire and arousal.

All the patients somehow suffered some kind of severe trauma in early object relationships (for example, it turned out that the mothers of all the patients suffered from postpartum depression in the first year of their daughters' lives and were treated with antidepressants), which led to an excessive intensification of fantasies associated with archaic ideas about the female body. The memories of this trauma sank into unconsciousness and turned into a "fantasy of Medea".

Women (mothers) are presented to us not only as a force that can give a person life, and with it invulnerability with a heavenly, orgasmic sense of integrity, but also as furies and avengers who, with severe humiliation, with severe pain, can take away the life they themselves gave.

These women carried an archaic destructive experience with them. Women perceive their bodies in a destructive context, as something that carries disappointment and generally deadness, as a source of uncontrolled aggressive impulses of the patient (they unconsciously associated themselves with the "dead female bodies" of their depressed mothers, which was the basis of their psychogenic infertility).

Their unconscious view of their own body was distorted due to the experience associated with maternal depression (the maternal object was recognized as inherently destructive). The oral stage of development was associated with a later, anal destructive one, which led to the idea of killing an Oedipal rival/competitor. Thus, the early stages of psychosexual development on the one hand and the unique personal experience of object relations on the other led to the formation of the Medea complex.

The "Medea complex", as an unconscious hatred of a mother for her growing up daughter, for a daughter becoming a woman (in the interpretation of Z. Freud). Freud mentions Medea only once in the description of one of his clinical cases: "The Story of Dora", when comparing the relationship between Medea and Creusa with the relationship between Dora and Frau K. Wittels (1994). E. S. Stern (Stern) (1948), in turn, noted that Medea had no daughters, but had two sons, thus, the same Medea complex is interpreted by him somewhat differently: like a mother's hatred of her offspring in general, reinforced by a desire to take revenge on the father of the children. ^[9] Reinhold suggested that all mothers are more or less characterized by the desire to kill their own children = female perversion at the present stage of research.

The theme of death is often heard in sessions. A real death or a fantasy one (expressed in the desire for death to someone close to you). Their mothers may have experience of abortions, miscarriage, fear that a stillborn child will be born, the experience of a "substitute child". Dreams about dead bodies (which reveal fantasies about the mother's body and her own body). Association with the dead = in one of my cases, a woman has a recurring dream – white lilies - these flowers, as she believes, are associated with possible death – I partially described this case in a work on the psychogenesis of female psychogenic infertility. ^[4]

Women suffering from psychogenic infertility unconsciously compare the mother's womb to a "dark, deaf cave" - bottomless – in which dead male semen and dead children have been stored for centuries. Sometimes they choose a partner who is against having children, thus, this choice protects them from archaic fears of becoming the person who will become the murderer of their children. Often there is no sexual relationship in such a couple or there are difficulties. Love relationships are built according to the type of child-parent relationship. A woman can act as a mother to her partner.   

Marianne Leisinger-Boleber constructed infertility factors: an unconscious attempt to protect herself from sexual passion, from impulses to kill her future children, as well as from a humiliating feeling of dependence on her sexual partner – all these are the main motives of Medea in the tragedy of Euripides.

Subconsciously, the femininity of women with psychogenic infertility is for them "a force that dominates life and death." This is due to archaic disturbing ideas about their own destructiveness – including the potential impulse to kill their offspring. The female body is perceived as a contradictory and essentially defective object associated with something archaically negative in bodily terms. The functions of the female body are perceived not as pleasurable, but as a terrible, unreliable and destructive power. Female genitals are perceived as instruments of "bloody reckoning" not only over women themselves, but also over a sexual partner, as well as over potentially possible offspring. Moreover, women subconsciously believe that their body belongs not to themselves, but to their mothers. ^[4] Everyone is alive, which means that "separation" did not happen, and their own borders and boundaries of objects were never developed or recognized. It is also a beacon of an unconscious attack on their mothers' bodies and, as a result, on themselves and their femininity.

In addition to everything else, the fact of defining themselves as women (in terms of sexuality and motherhood) means for them only endless subordination to their sexual partner and the father of future children. This manifests itself in infertility, man-hating and envy of having a penis, as well as in panic anxiety from the possibility of being abandoned and betrayed. ^[4] Sexuality and motherhood begin to compete with each other, but in any case they are perceived by women as the loss of personal boundaries, the loss of oneself, and are associated with inevitable aggression and libidinal affects. The combination of sexuality and motherhood is perceived as destruction for the individual and for the object, as "death" and "depression" (loss of self). All the women were convinced that only one participant could get out of this "battle" (pregnancy and birth) unscathed: either a mother, or a child; or a person, or an object.

The women described in this paper unconsciously used their bodies as protection against future shocks: their psychogenic infertility and frigidity prevent "merging" with an object during intimacy. Women are afraid of close relationships.

And the final idea that allowed us to think about the problems of perversion and the feminine, and which requires time for reflection, is female perversion (expression of a form of hatred) and female infertility. With impaired motherhood, an introjected mother can be a perverse object.^[5]

We conducted a psychoanalytic study of unconscious maternal conflicts in five women suffering from psychogenic infertility. The study was conducted in 2021. Research methods were used: "Metapsychological assessment of adult personality – Adult profile" (according to A. Freud, W. Nagera, E. Freud), interviews on attachment research according to D. Bowlby, analysis of the level of personality organization and its structure (primary interview according to M. Balint and E. Balint).  For additional evaluation, projective techniques were used: the drawing "Mother and Child" by M.L. Melnikova; the drawing "My body" by K.Mahover, F.Goodinaf, the TAT test by G. Murray. The study involved 5 women suffering from psychogenic infertility.

The following research results were obtained. In the first case, the woman had a frozen pregnancy as a result of infection with damage to the reproductive organs and placenta. In the second case, there is also a frozen pregnancy, but with the absence of an embryo as a result of a conception defect. In the third of the presented cases, it was a question of inhibition of fertile function with a violation of the menstrual cycle and failure to conceive during 8 years of normal sexual life. In the fourth case, conception does not occur after 4 aborted pregnancies. In the fifth case, the woman had rejection of a 2-month-old fetus after an IVF procedure using donor material. Medical studies conducted both in women themselves and in their partners have not shown the presence of organic pathology leading to the impossibility of conception. All this indicates the psychogenic somatic nature of infertility.

In all the cases under consideration, similar prerequisites for the formation of psychogenic infertility were identified. Unconscious maternal conflicts in three generations, obtained by transgenerational transmission, were revealed in three women. At each stage of transmission, these conflicts were modified in the direction of aggravation, and in the last generation they became a source of formation of their own internal conflicts, under the influence of which a specific type of personality of a woman who is experiencing difficulty or unable to conceive, carry and give birth to a healthy child was formed. 

Oral fixation is pronounced in the women studied. Their mothers were more or less deprived, as a result of which object relations turned out to be deficient (the phenomenon of the "dead mother" arose). As a result, it was possible to connect emotionally with such a mother only during feeding. Their ego is diffuse, the type of attachment is alarmingly ambivalent, or rejecting. The development of the Ego is negatively affected by libidinal deficiency, which arose as a result of unsatisfactory relationships with primary objects.

All the women studied function at the borderline level with a pronounced narcissistic and paranoid radical. Such "paranoid narcissism" is characterized by anxiety, suspiciousness, and most importantly, fears of not being seen, not heard, not appreciated. We consider the reason for this to be the presence of the Ego Ideal, whose demands are almost impossible to satisfy. The ego, with its weak defenses, is neither able to meet these requirements nor to resist them.

The first link in the chain of transgenerational transmission of unconscious maternal conflicts available to us for research, which directly affect the women studied, are conflicts of prenatal nature. They are expressed in the tasks assigned to the unborn child, who is obliged to meet certain tasks and expectations of the mother. As a result, a leading authority is formed in the structure of the daughters' personality  I am an Ideal whose demands are almost impossible to satisfy. These requests are modified during intergenerational transmission and move from: for example, in the previous generation: - "You can only have sex in marriage, you must do everything as your mother sees fit" to: in the next generation: - "Become a boy, become my mother, become my husband." Using the example of the five women studied, we see how such maternal projections contribute to the formation of a specific personality that is experiencing difficulties with childbirth.

The next characteristic feature for all the subjects is that their mothers, as a result of traumatic situations that happened to them, during childbirth, the injuries were reactivated and the women could not contain their children, but on the contrary, used them as containers. Then, by about the age of 2-3, these depressed mothers became active, and they began to compensate with overprotection for the lack of communication with the child in the oral period. This could prevent the girls from going through the separation normally and served as a source of false self development.

Another false formation in the psyche, characteristic of the women studied, arising under the influence of unconscious maternal conflicts, is pseudoedipality. Against the background of an initially depressed and then aggressive mother, whose goal is to take control in order to cover her deficiency, and who is represented in the psyche as a haunting terrifying object, an idealized father appears, who is chosen as an object for identification. This is necessary for the child in order to idealize his own parts of the self that need love and care, but as a result, development continues only to the genital stage, identifying himself with a phallic - idealized father, whose condition of existence is the satisfaction of an insatiable mother who sacrifices himself. As a result, the girl, fulfilling her mother's order, takes the position of her mother's partner and begins to take care of her - which we found in the study.

Regarding gender identity, women identify themselves with a male figure (father). They feel like a male child, as most of the subjects expressed. Some women note that they replaced the male figure in the family and often acted as "men" for their mother, that is, they solved the issues and tasks that the man in the family had to solve. Often, mothers neglected girls and used them to resolve their latent homosexual urges (they shared a bed with their daughter for a long time, the father moved to another bed), which inhibited the psychosexual development of the girl.

The traumatic experience of previous generations of women, where the latter is mentally infertile, is represented by the presence of a huge number of transmission objects in the form of unplanned losses of experience of rejection, betrayal, deaths and abusive relationships.

Through transgenerational transmission, this experience is transmitted from mother to daughter in the form of unconscious maternal conflicts and when an experience of severe frustration, emotional abuse and rejection occurs, a woman has an aggressive attack on her offspring, thus a "Medea complex" is formed from generation to generation, which in the last generation strengthens infanticidal impulses and finally provokes infertility. In this case, the future child is endowed with such terrifying projections that meeting with him becomes impossible and he is rejected in every possible way.

Returning to the topic of the article and the idea of a different identity from the mother's, let's turn to the ideas of E. Patis-Zoya. The author considers pregnancy, abortion and motherhood as initiation.  And he identifies two ways of female initiation in the modern world – motherhood and masculinity. The author considers pregnancy as a confirmation of fertility, self-renewal. "A woman wants to be pregnant not because she wants to have a child, but because she wants to become different: better, stronger, more feminine, more perfect, more accepted, more like herself," concludes Ye. Pattis-Zoya ^{[6, p. 52]}. Unwillingness to get pregnant is equivalent to saying no to "everything": no to motherhood, no to the spirit of maternal self–sacrifice, rejection of the attributes that define femininity. To say yes to myself. It's a choice a woman makes between being herself and being a mother. She can sacrifice herself or motherhood, and at the same time the child in the womb. This is how E. Pattis-Zoya comes to maternal and non-maternal femininity. It raises the question of whether a woman's femininity is in motherhood or something else. It can be assumed that a woman suffering from psychogenic infertility acquires femininity and identity in a different (in this context) from the maternal one. Her femininity exists in the realm of aggressiveness. 

Conclusion

The formation of a personality in a woman's adult life is primarily determined by her relationship with her mother. A girl's perception of her body is formed in the process of bodily contact with her mother, starting from birth and infancy. The process of forming a female identity is influenced by many factors.

The traumatic experience of previous generations of women serves as the basis for the formation of distorted ideas about their bodies, pregnancy and motherhood. This leads to the fact that subsequently these women experience a strong fear of pregnancy, and infertility arises in them as a psychological defense formed by the contradiction between the conscious desire to become pregnant and the unconscious rejection of pregnancy and motherhood.

Unconscious maternal conflicts in the process of intergenerational transmission in the form of transmission objects charged with suppressed sexuality and aggression strengthen the infanticidal moods of women suffering from psychogenic infertility in the last generation. The phenomenon of hereditary succession of female cruelty and destructiveness, the basis of which is the relationship between a woman and her mother and the unconscious conflicts connecting them, is identified by a number of authors with the figure of the mythological heroine Medea.

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