To reveal or not to reveal a secret.

As the physiological birth of the human infant precedes the psychological birth, the technology that has enabled birth of a child through donor fertility treatments may precede the psychological birth of the parent to such a child. The clinical vignette describes the therapy of a man preoccupied with the secret that his children had been conceived by artificial insemination due to his own infertility. His quandary over whether to keep the secret or reveal it to those close to him, and if so, then when and how, sapped his emotional energy, dragged down his spirits, and unsettled his life. The preoccupation with the secret and the question whether to keep it or reveal it, constitutes an organizing and containing envelope for other concealed issues and unconscious conflicts seeking revelation: who am I and where did I come from? Unsatisfactory answers to these fundamental questions during the pre-oedipal and oedipal stages of development can create a difficult dilemma to overcome.