The authors discuss an application of Bion's conceptualisation of thinking and non-thinking states (K and -K links) to the treatment of a nine-year-old girl. The authors consider Bion's interrelated concepts such as K and -K, container/contained, maternal reverie, and the development of thinking through alpha function to be highly applicable to…

This paper takes Betty Joseph's concept of "addiction to near death," which describes a clinical situation in which sadism and masochism dominate the relationships of a particular group of patients, and applies it specifically to the case material of a girl in adolescent psychotherapy treatment. A link is made between the patient's retreat from…

The author describes a sub-group of anorexic patients who present themselves clinically as "invisible" and "insubstantial". The concept of "invisibility" is understood in terms of primitive object relations. The underpinning of this dynamic is a lack of separation and differentiation from mother and a consequent effort to live inside her skin. The…

This paper shows a child psychotherapist learning and developing her technique as she attempts to make contact with a child who is extremely hard to reach. It is based on the first two years of three-times-weekly intensive psychotherapy of a latency girl who had little faith in a helpful therapeutic relationship. Her defences against such a…

This paper describes the once-weekly psychoanalytic psychotherapy of a girl, called Ellie, aged eight at the start of her treatment. Ellie had a learning disability and displayed difficult behaviour at school and at home. In her therapy, Ellie grew in emotional intelligence, more in touch with and able to express her feelings. Her behaviour…

This paper is an account of the intensive psychotherapy of a young girl on the autistic spectrum. It describes her confusing presentation and how this suggested a tendency to oscillate between mainly unintegrated states of mind. Important themes that emerged included the phantasy of inhabiting a claustrum; the use of adhesive identification to…

The objective of this study was to evaluate the outcome of child psychoanalytic psychotherapy in a clinical outpatient setting in a city in southern Brazil. Three psychological tests (Rorschach, Bender and WISC III) were administered to 23 children, aged 6-11 years old, and the Child Behaviour Check List (CBCL) was completed by the parents. All…

The power of new traumatic events to reignite memories and the distress of traumatic experiences earlier in life is well known to psychotherapists. When the recent trauma has been extreme, the task of assisting the patient to understand their response in the light of their earlier experience can be doubly challenging. This paper describes the…

This paper describes the struggle to develop a female sexual identity and the importance of the roles of the father and mother in this struggle. The clinical illustration is taken from the psychotherapy of an anorectic adolescent.

In this paper the course of the therapy of an adopted latency-aged girl is described in some detail. There was considerable improvement outside the sessions while within sessions she remained a not-very-vocal child and continued to play in the way that a younger child might. The clinical material is examined in a discussion of the possible…

In this paper, I describe the first 2 years of intensive psychotherapy of a multiply traumatized 5-year-old girl. I explore some of the ways in which violent and traumatic experiences were re-lived in the therapy and how they impacted on both patient and therapist. Within the discussion and illustrated by clinical vignettes, I consider the…

This paper examines some of the research on imitation that shows it to be much more than simply a behavioural or reflex response, but rather an aspect of the growth of genuine social and psychological interaction and part of an intersubjective process that includes the representation of object relationships. Differentiations between mind,…