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This stimulating panel discussion promoted thinking about adult, as well as child, analysis. The tasks of acknowledging affect and of distinguishing between fantasy and external reality, aspects of treatment addressed by the panelists, confront adult and child populations with equal poignancy.
Karen Gilmore introduced the panel by highlighting general issues regarding play in the session and focusing on play as central in the analysis of prepubertal children. Increasingly, she stated, play has come to be understood as serving a crucial role in child development: “The ability to play is viewed as a developmentally determined capacity with strong biological foundations serving a range of social, interpersonal, and intrapsychic functions, and observable in the young of all cultures, mammals and birds.” From a psychoanalytic perspective, play evolves with cognitive and psychological development and is growthpromoting despite its potential to be recruited to conflict.
In the evaluative phase of treatment, playing with the child serves as a diagnostic tool for assessing trauma, level of ego organization, and degree of constriction, disorganization, or impoverishment of inner life. The individual's psychological and cognitive development and degree of interpersonal relatedness are revealed through play; similarly, shifts in play can provide evidence of progress in the course of treatment.
Throughout a child analysis, play remains a primary means of communication, revealing the child's coping strategies and, especially, serving as the primary medium for the playing out of interactions among the child's unconscious, the object world, and the transference relationship. Whatever problems may deform the child's play function, the child analyst anticipates that most children “will produce some form of play that can serve as a shared region … where the action of the