Freud's Impact on Therapeutic Work with Children

Freud's influence on the understanding of infantile sexuality and the development of the child has been well documented in the psychoanalytic and popular literature, as has his influence on therapeutic work with adults. Freud's influence on therapeutic work with children, however, has not been fully appreciated. It is generally accepted that the first psychoanalytic therapy of a child was the analysis of Little Hans. The purpose of this essay is twofold: (1) to trace the impact of Freud's contributions on what is currently considered the optimum therapeutic approach to children; and (2) to frame the analysis of Little Hans in its historical context.

In “Analysis of a Phobia in a Five-Year-Old Boy,” Freud (1909) described the course of the illness and recovery of a young patient. Freud reported the development and resolution of Hans's phobia. The therapy was conducted by the father. On a sometimes daily basis, the father talked with Freud about his son's difficulties and reported his conversations with his son. In the course of these talks, Freud instructed him in how to understand and handle the case. Freud only saw the boy once during the treatment.

At age three, Hans was showing a rather lively interest in that part of his body he called his “widdler.” His thirst for knowledge was inseparable from his sexual curiosity, which was focused on his parents' “widdlers.” At age three and a half, two traumatic events occurred: his mother threatened him with castration because he was masturbating, and his sister was born. At age five, he had an anxiety dream that his mother was gone, and as a result, his affection for his mother intensified. Hans would come to his mother's bed in the morning to be caressed by her, in defiance of his father's wishes. He became afraid of horses because they had big “widdlers.”

After an attack of influenza, his fear of horses increased so much that he refused to go out. The immediate precipitating event of the phobia was the fall