Encountering a cartwheeling princess: relational psychoanalytic therapy of a child with attachment difficulties and ADHD

Abstract

Objective: This study was conducted to demonstrate the use and process of contemporary relational psychoanalytic child therapy to address the interpersonal implications of attention deficit hyperactivity disorder and interlinked insecure attachment processes.Method: This therapy case study explicates the seven-month therapeutic process of a seven-year-old girl child highlighting the need for the child therapist to balance interventions aimed at both the internal and external world of the child. In essence, this account traces therapeutic scenarios of both painful and joyful material by means of paying close attention to the entwined transference and countertransference dynamics as well as creatively and authentically engaging with the child's way of making sense of self-states, others and even medication.Results: Key features of this account include the foundational role of assessment and the compelling mediating role of a puppet as a co-therapist within the analytic space between psychotherapist and patient.Conclusion: Uniquely, as an inclusive psychoanalytic therapy, relational psychoanalytic child therapy reconfigures internal object relations of the child while simultaneously ushering changes into their familial and school context by utilising the mutuality established between the child and therapist as a central pivot.