Life beckoning. A thematic analysis of change in a deprived boy in long-term foster care, during intensive psychoanalytic psychotherapy

Abstract

This research is based on a single case study of psychoanalytic therapy with a young adolescent boy in care. It is part of a growing movement to identify research methods for exploring the place of unconscious expectations, emotion and affect, in relationships. It experiments with methods for testing out psychoanalytic theory and contributing findings to evidence, modify or expand theory in new directions. The patient Simon, had a history of deprivation and showed many features of ADHD and oppositional conduct disorder. The research locates him in a “family” of children who share histories of early traumas and serious behavioural difficulties. Therefore findings, while grounded in clinical material from a single case, and restricted in scope, are of relevance to work with a very needy and challenging population of children, who are often a major cause of concern to their carers, teachers, social workers and to mentalhealth professionals. The research examines clinical material through the framework of Bion’s theoretical claim that identifies thinking as at bottom an emotional process, and relates symbolic capacity to early emotional experiences of communication and containment. The framework was selected because of its relevance to the particular features of the patient, which emerged through the detailed study of session records. The analysis of patient therapist interaction follows Bion in looking at thinking and learning, side by side with the sort of internal objects active in the therapeutic relationship, and the emotions connected to them. Through a detailed focus on these aspects of clinical material, the author assesses some current ideas about what interferes with a deprived child’s capacity to think and learn from experience; and what are the factors in a therapeutic relationship that can help a child’s capacity in these areas to grow.