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Chapter 24 - Working Psychotherapeutically with Children
- from Section 2 - Work in Practice
- Edited by Rachel Gibbons, Jo O'Reilly
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- Book:
- Seminars in the Psychotherapies
- Published online:
- 27 May 2021
- Print publication:
- 10 June 2021, pp 312-322
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- Chapter
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Summary
The essential goals of the child and adolescent psychotherapist are not dissimilar to those of the adult therapist: to understand and render meaningful troubled aspects of the personality. The process brings insight to bear on the nature of the internal world and its mixed population of figures, benign and persecutory. Mental development occurs not so much through ‘ironing out’ the difficulties, but rather through ‘an increase in the capacity to bear reality and a decrease in the obstructive force of illusions’ [1, p. 51]. Bearing reality lies in being able to reintegrate aspects of the personality that have been disowned, or disavowed as too threatening to psychic equilibrium. The process of integration involves taking back projections and bearing the discomfort of being brought into relation with the less manageable aspects of the self. The method is based on the observation and interpretation of the transference and countertransference relationship, the elucidation of dreams and, in the case of children and adolescents, the underlying meaning of play and enactments of whatever kind that take place both in and outside the consulting room.
4 - Growing up female
- from Part I - Women in perspective
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- By Margot Waddell, Fellow of the British Psychoanalytical Society and a Child Analyst
- Edited by Kathryn M. Abel, Rosalind Ramsay
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- Book:
- The Female Mind
- Published online:
- 02 January 2018
- Print publication:
- 01 October 2017, pp 23-28
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Summary
‘It is the hour of the stranger. Let the stranger now enter the soul.’
– D. H. Lawrence (1923)It is over 90 years since D. H. Lawrence gave this eloquent evocation of the ordinary, yet extraordinary, impact of puberty on the personality and the ensuing course of adolescence. Yet adolescence remains the ‘hour of the stranger’, when the personality painfully develops into its adult self. Lawrence does not make gender distinctions, but there are significant differences between growing up female and growing up male. Below are some comments from girls attending a specialist adolescent clinic.
• ‘I cannot bear mental pain.’
A 17-year-old, whose left arm, covered with scratches and scars, told a desperate story, physical evidence of her inner psychological pain that she needed to inscribe on her own body in an attempt to get rid of inner, unbearable tension.
• ‘I feel depressed and unlikeable. Basically, I hate my looks. I'm fat and ugly. I don't smile anymore – only when I puff or get drunk.’
A 14-year-old with anorexia.
• ‘I didn't feel wanted at home. I was always rowing with my mum and her new boyfriend. I suppose I just wanted someone to love me unconditionally – someone I could love too.’
A pregnant 15-year-old.
• ‘I wake up in a panic most nights. The exam pressure is impossible. I just want to cry all the time. It's hopeless.’ An 18-year-old.
Each of these statements is a powerful expression of the intensities of adolescent pain and confusion, and of the often unstoppable urge to act, or act out – that is, to attempt to manage internal conflict by action, rather than by thinking or feeling. Girls tend to act against themselves, as a result of intellectual pressure, depression, poor body image, lack of self-esteem and separation anxiety (this last taking the form of a fear of rejection). The statements describe responses to unmanageable states of mind, and the problems they describe will be familiar to many.
What happens in the mind (the internal world) cannot be separated from what happens in the body and external world.