Child Analysis and Horney Theory

In this paper I wish to regard child analysis within the framework of the Horney theory. While the spirit of that theory is of greatest importance for the treatment of all patients, it has specific positive value for work with children. A full critical evaluation of other psychoanalytic approaches will not be made, although some comparisons with Freudian theory and method will be indicated.

Some special problems arise in the treatment of children. The first is that the decision to seek analytic help does not come from the child, but rather from the parents or some other authority such as the school or the Children's Court. This would seem to make the child a pawn, the object of coercion. It has been pointed out that the child rarely suffers from his neurosis—rather it is the environment that is disrupted by the child's illness. Because of this, it is felt that motivation for cure is absent, and the analyst is deprived of a valuable ally.

The second problem is that the child, particularly the young child, does not as a rule have a facility with words, nor the capacity for conceptualizing or connecting ideas in verbal form. This is less true with adolescents or with certain children whose language precocity may be the expression of a mental development precipitated by inner conflicts.

A third problem is the child's refusal or inability to associate freely. He seems to lack an interest in self-examination and the ability to observe his thoughts for subsequent evaluation. Thus the analyst is deprived of an important investigative tool. Fourth, children tend to act out, to be more expressive manually or physically. This means that in the course of analysis, the tendency to externalize difficulties and to take direct action on the environment would diminish intrapsychic tension.

The child's realistic dependence on adults for his very existence adds a fifth problem to the treatment situation. Because of the still existing parent-child relationship, another important therapeuti