Child Analyst Research Articles

An integrated theory for Attention-Deficit Hyperactivity Disorder [ADHD

Attention-deficit hyperactivity disorder (ADHD) is a commonly diagnosed condition of childhood, thought to affect 3 to 5% of all school-aged children (Buitelaar, 2002). In spite of the prevalence of ADHD, there is no consensus between child psychoanalysts and child psychiatrists about its aetiology and management. This is despite (or perhaps because of) the fact that the core symptoms of age-inappropriate hyperactivity, inattentiveness, and impulsivity (Kaplan, Sadock, & Grebb, 1994) can be conceptualized in the terms of both schools of thought. However, if we retreat to separate and distinct conceptualizations there is a risk that the lack of an integrated theory may have adverse consequences for those we attempt to treat. In order to avoid this, we need to re-examine the core psychoanalytic perspective in the context of current neuropsychiatric perspectives in order to clarify our understanding of this condition and better help the children in our care.

Losing a Father All Over Again: the Termination of an Analysis of an Adolescent Boy Suffering From Father Loss

Criteria for beginning and conducting the termination phase of psychoanalysis have provoked debate and confusion from the early days of psychoanalysis. Gabbard (2009) has recently pointed to the field's tendency to cling to idealized versions of these criteria as a way to deal with disagreements. The situation becomes more complicated for child and adolescent psychoanalysts because their patients are in the midst of a developmental process at the very time they are engaged in a psychoanalytic process. The termination phase of an adolescent male suffering from father loss is presented in depth in order to provide clinical data toward further consideration of the vexing questions surrounding termination in psychoanalysis. His termination is used to examine the relative importance of losing the analyst as a transference object as against a developmental object; the meaning of action during termination; the complicating role of trauma vis-à-vis termination; and the importance of the post-termination phase of analysis. It is suggested that his termination phase demonstrates that a "good enough" termination involves the development of a self-analyzing capacity that continues to evolve and develop after termination.

Kyle and the Basilisk: Understanding Children’s Writing as Play

In this article, Boldt considers decisions teachers must make about the value of children’s writing as a form of play in primary classrooms. She offers a brief history of the framing of this question at 1966 Dartmouth Conference on English, focusing particularly on the perspective of Jimmy Britton. She highlights the relationship between Britton’s work on play and fantasy and that of his brother-in-law, the child psychoanalyst D. W. Winnicott. Reading across their publications on play and fantasy, she has drawn out the argument that their work was motivated by a mutual concern about the dangers of orthodoxy, compliance, and what Winnicott referred to as a “fascist state of mind." She highlights that what they advocated for was a set of playful practices, including Britton’s understanding of children’s writing as a form of play, that were grounded in a deep concern that classroom pedagogy could contribute either to children’s sense of social responsibility, artistic and creative potential and emotional security, or to fear, rigidity and conformity. She argues that to return to this set of concerns is particularly timely in today’s accountability-driven environment.

Susan Isaacs: a life freeing the minds of children

This biography provides a critical account of the life and work of Susan Isaacs (1885-1948). This educationist, a pioneer of child-centred education in Britain was also an early and historically important child psychoanalyst. She is described in the Oxford Dictionary of National Biography as the greatest influence on British education in the twentieth century. Yet she is virtually unknown in both educational and psychoanalytic circles. When Melanie Klein was threatened with expulsion from the British Psychoanalytic Society she was by far her most powerful advocate and thus played a major role in determining the direction of British psychoanalysis from the 1940s onwards. This book provides an account of her life and contains much intimate material about her childhood, her marriage and her work that was previously unknown. It gives a fascinating insight into many facets of her life and concludes with an appraisal of her impact on the worlds of education and psychoanalysis.

A Cross-Sectional Survey of Child and Adolescent Analysts in New York City

The field of child and adolescent psychoanalysis has been considered an endangered specialty for many decades. This study surveyed the nature of the practice of child and adolescent analysts (graduates and candidates) affiliated with three institutes accredited by the American Psychoanalytic Association in the New York City area. Sixty-one percent of those surveyed (63 of 103) responded. The child and adolescent analysts in this cohort treat a total of 201 adult, child, and adolescent analytic cases (M = 3.2, SD = 2.6). Of these cases, 17% are at a three-times-weekly frequency. Child and adolescent analytic practice is small, with a total of 56 analytic cases (M = .9, SD = 1.2). While 64% of these analysts have no child or adolescent analytic cases currently in treatment, 24% have very active child and adolescent analytic practices, conducting 73% of all the child and adolescent analyses reported. Implications of these findings and recommendations for future work are discussed.

Child Analytic Training: the Establishment of a Separate Training Track At Institutes of the American Psychoanalytic Association

In 2002 a pilot program was established under the auspices of the American Psychoanalytic Association, with the participation of four of its institutes, to study the feasibility of creating a separate training track in child analysis without the requirement of previous adult analytic training. The program, which ran from 2003 through 2006, was evaluated by a research project completed in 2007. These efforts resulted in the formal creation of a separate training track in child analysis to train child analysts only. The experience of two of the pilot programs, which required the analysis of three children and one adult, is described.

You Can't Do That — Or Can You? Historical and Clinical Perspectives on Limit Setting in Child Psychotherapy

Early child analysts favored a permissive approach in treatment rather than one that valued limit-setting; this paper suggests that a return to this early analytic practice can be productive. Clinical examples are presented of children who were brought to treatment with limit-setting difficulties and were offered treatment where only the time of sessions was limited. These children tested limits, broke rules, acted out, and misbehaved in the early stage of their treatments. They attempted to engage their therapist in the power struggles that were so common and comfortable for them in their experience with authority figures. Gradually, they developed dissatisfaction with their struggling and rule-breaking, an interest in controlling their own behavior, and the ability to do so. For these children, the ability to experience themselves as out of control was an important precursor to their developing internalized controls; as long as authorities demanded that they control their behavior, they experienced the power struggle, but not their own need for control. In the absence of external controls, they were able to decide to limit themselves; this allowed them to become allied with the therapist in facing their dynamics and difficulties in other areas.

Anna Freud: a biography

This edition of Elisabeth definitive biography of pioneering child analyst Anna Freud includes--among other new features--a major retrospective introduction by the author. Praise for the Second Edition: Young-Bruehl's description of one of the most complex but brilliant lights in psychoanalytic history has stood as a beacon to students of psychoanalytic history. It is the best most carefully crafted biography of any psychoanalyst and it illuminates the entire tradition with a clarity that only the exploration of the life of the daughter of the founder of the movement could possibly provide. It is a beautifully written insightful and remarkably edifying piece of work. The best has just got better.-- Peter Fonagy, Freud Memorial Professor of Psychoanalysis, University College London Praise for the First Edition: A gem of biographical writing...--Ron Grossman, Chicago Tribune Lucid, erudite, briskly authoritative, Elisabeth Young-Bruehl ...has given us the insight into character that makes biography an art. --James Atlas Elisabeth Young-Bruehl is a faculty member at the Columbia Center for Psychoanalytic Training and Research and a practicing psychoanalyst in Manhattan. She lives in New York and Toronto.

Dr Cecil Todes

Cecil Todes was born on 29 May 1931 in Johannesburgh, South Africa. Todes was a consultant child psychiatrist, psychoanalyst and author of an original, and now classic book, about his own Parkinson’s disease, Shadow Over My Brain . On its first publication, in 1990, the book was highly praised in

Interdisciplinary Psychoanalysis and the Education of Children

Since the original "Wednesday night" meetings Sigmund Freud and ensuing generations of psychoanalysts have been interested in applying psychoanalytic discoveries to the education of children and adolescents. Child analysts and educators are potentially natural allies: both are concerned with promoting children's healthy development and capacity to learn. This paper traces and critiques the inter-generational history of the four major ways that analysts have worked with educators: directing psychoanalytically informed schools; consultations; developing replicable programmatic school-based efforts; and working with colleges of education and/or continuing education for practicing school personnel. Finally, I describe similarities and differences between clinical and applied work as well as how the following three steps will further fruitful interdisciplinary work and learning: including and valuing applied analysis within psychoanalytic institute curriculum; creating more forums where analysts and non-analysts can learn from one another; and, most importantly, supporting the systematic study of applied analytic efforts.

Education section: Infant observation in Britain: The Tavistock approach

The author draws attention to something distinctive in the psychoanalytic ‘air’ from the early 1960s onwards: the strong emphasis upon the very early psychological, emotional and cognitive view of infants and young children. She focuses on the work of two analysts in particular, Esther Bick and Wilfred Bion, and the comparable, though differently expressed, centrality of the observational method in their work. Each explored not only the pathological picture but also the nature and integrative function of psychic containment in earliest mental life. Each also shared a preoccupation with what constituted a psychoanalytic attitude and with the process of becoming a psychoanalyst and, in Bick's case, a child analyst or psychotherapist. The author provides an historical background to the idea of observation, followed by an account, with detailed examples, of the nature of infant observation and the observational method as taught and practised at the Tavistock Clinic, London since the late 1940s, and subsequently in many other training institutions. Here the themes of Bick and Bion are constantly interrelated such that the prototype or model for the creation of emotional meaning and thought can be appreciated and learning from experience can take place.

Appetizing Loss: Anorexia as an Experiment in Living

This paper turns upside-down the commonly held assumption that anorexia nervosa is inherently destructive or counter-productive. The author delves beneath the façade of anorexia’s main symptom, self-starvation, to explore what refusing to eat accomplishes, psychically, for the sufferer. Featured in this paper are the clinical reflections of contemporary child analyst Adam Phillips who argues that symptoms, such as those in anorexia, are “experiments in living.” In his view, anorexia is a particular way of testing the environment for its capacity to withstand and satisfy one’s desires. Working also with the notion that anorexia is an attempt at compensation for traumatic loss or affective rupture, attention is drawn to both the inter-personal and intra-personal contexts within which self-starvation is pursued. Importantly, this approach recognizes that responses by those around the anorexic individual affect the conditions within which possibilities for recovery are made. Special thanks to Lesley Biggs, Donald Brackett, Dara Gellman, Marla Gerein, Kelley Lewis, and Melissa White, who commented on a draft of this paper. I have taken up many of their suggestions in its revised version.

Exploring the Role of Children’s Dreams in Psychoanalytic Practice Today

The aim of this research study was to investigate the role of children's dreams in the practice of child psychoanalysis today, and to explore contemporary psychoanalytic understanding of children's dreams. This pilot study consisted of two stages. The first involved a document analysis of published articles in The Psychoanalytic Study of the Child, making a comparison between those of the early 1950s and the 1990s, in order to see in what way the discourse around children's dreams within the psychoanalytic literature has changed over time. The second stage, based on questionnaires and in-depth interviews, attempted to understand in more detail the way contemporary child analysts, working in the Anna Freudian tradition, think about dreams and use them in their clinical practice. Results suggest that there has been a decreased focus on dreams in a clinical context over time, and that this may partly be a consequence of changing theoretical models and changes in training. When work with dreams does take place, it appears that child analysts have

Influential Papers From the 1920s

Influential Papers From the 1920s

Discussion of Joseph Newirth's Clinical Material

This paper originated as my contribution to a panel discussion offering differing theoretical and technical points of view. It was based on Joseph Newirth's detailed process description of two clinical sessions of an ongoing analysis. Utilizing Bion's concept of the “psychoanalytic game,” the material is played with from the Kleinian-Bionian perspective of an experienced adult and child analyst. My model of mind addresses with facility the “child in the adult” of the patient, using concepts of an internal family of mother, father, little-boy, and little-girl parts, noting and clarifying misconceptions, misunderstandings, and misapprehensions, as well as a striving in the patient toward truth, beauty, and goodness under the aegis of the primacy of life forces. The impact of concrete thinking on perceptions of reality is addressed in the clinical material.

What does the child analyst bring to Jungian thought?

The author wants to show the influence that the historical acknowledgement of child therapy at the Jerusalem IAAP Congress in 1983 has had today on the Jungian world, especially on the clinical approach to their patients by analysts working only with adult patients. If her conclusions do not allow her to dissociate the strong influence on psychoanalysis of contemporary research on attachment theory and mother-child relationship from a specific Jungian child therapists' perspective, she points out, through three examples from Jungian literature, how the need for a metapsychology of development and the study of primary and personal aspects of the patient's life are explicit in the work and research of analysts working with adults.

How Can Psychoanalysts Help Parents and Teachers Work Together?

There is a reason that we are having a discussion on how teachers can work more effectively with parents. Despite knowing, from research and from common sense, that parents are an essential part of the team, both teachers and psychoanalysts often have avoided genuine engagement in either the school or clinical setting. A nursery school director whom I greatly respect told me recently that she felt she had “run from parents for twenty years.” Many child and adolescent psychoanalysts are trained to have as little contact with parents as possible, and many plausible theoretical rationalizations are advanced to support this practice. So we know we are all in trouble. I have experience in dealing with this issue in two situations. In my clinical work during the last forty years, I shifted quickly from the traditional position, which we might call “isolationist,” to feeling that parent work is an essential component of all child and adolescent treatments. Indeed, my husband, Jack Novick, and I have just written a book called Working with Parents Makes Therapy Work—so it is evident how radically my approach has changed. Another interest throughout my career has been working in schools as a consultant, as a teacher, and, now, as an administrator in a psychoanalytic preschool. One thing that makes Allen Creek Preschool a “psychoanalytic school” is the degree to which all programs, policies, and procedures are thought through in terms of development—that is, in relation to what we understand from psychoanalysis about what contributes to mastery, competence, happiness, kindness and creativity, problemsolving, and initiative. We serve families with children from birth through age six and have the unusual opportunity to follow the

Working psychotherapeutically with infants and young children: The contribution of experimental studies

In this paper a Jungian child analyst describes how the contributions of developmental psychology have influenced her understanding and work. Focusing on experiences of being told ‘no’, she draws on a psychoanalytic observation of an infant at the end of the first year and clinical vignettes of a young toddler and a six-year-old boy to illustrate the children's responses at particular points of development. In her discussion she describes how interventions following prohibitions promote development rather than restrict it.

Emergencies of Survival’: Moral Spectatorship and the ‘New Vision of the Child’ in Postwar Child Psychoanalysis

Drawing on the writings of Luc Boltanski on moral spectatorship and a change to Boltanski’s politics in response to images of distant suffering, this article considers a visual turn in psychoanalysis around the period of the Second World War, coincident with the emergence of a new international vision of the child as an entity requiring special protections beyond the purview of the state. Looking beyond the familiar example of child psychoanalyst Melanie Klein, this article considers the visual techniques of RenÈ Spitz, a psychoanalyst internationally recognized for his work with institutionalized infants who failed physically and psychically to thrive and survive despite adequate nutrition and health care, due to lack of consistent caregiving. The article describes Spitz’s research films which he turned into media texts to make social interventions internationally in institutional childcare practice and policy after the war through venues including the WHO. His work is one of numerous instances of a visual child psychoanalysis (including Anna Freud and Dorothy Burlingham, John Bowlby and James Robertson, Margaret Mahler, and Thelma Fraiberg) in which child psychoanalysts used film and visual techniques to exert influence on international child policy and institutional reform.

Dimensions of the Child Analyst’s Role as a Developmental Object

This paper will attempt to explain certain dimensions of the child analyst's role as a developmental object in an effort to better clarify the nature of that function as well as demonstrate that it is an important part of most child analyses. A review of the literature reveals a bias toward differentiating this function from that of promoting insight with the belief that these two functions determine different treatment modalities. Therefore, many authors suggest that being a developmental object is necessary only in the treatment of seriously disturbed children and/or those whose familial histories require a departure from a "genuinely" analytic stance. A case of a prelatency boy is presented to demonstrate the child analyst's need to serve as a developmental object in regard to setting limits in order to promote affect regulation. Closer scrutiny of these interventions raises the possibility that they may simply have been transference of defense interpretations at a concrete level commensurate with the child's level of cognitive development. This possibility is highlighted as an area for further study.