Discussion of “Tyler in the Labyrinth: A Young Child’s Journey from Chaos to Coherence”

Abstract

Dr. Pass (this issue) recounts her sensitive work with a traumatized boy and his grandmother. She describes an impressive and convincing therapeutic result. She articulates the theories that inform her work. I ask her for fuller clarification about what she actually does and says. In addition, I organize my remarks around the apparent differences rather than the similarities, which are substantial, in our ways of working and which reflect our implied differences in theories of therapeutic action. Even in the later phase of treatment, she seems to depend on the relational experience rather than thinking it important to verbalize and communicate within the relationship and/or in displacement his unique patterns of relating, inherent fantasies and conflicts. When T has more cohesive mature fantasies, patterns of relating and is capable of utilizing the metaphors of play, she does not appear to think in terms of transference; nor does she shift her way of thinking about him and, therefore, her way of working with him. I highlight Dr. Pass’s handling of several dimensions of treatment, such as, transference, the importance of what is spoken and/or experienced and the nature and fate of the remaining difficulties which likely persist at the time of the termination of the treatment.