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This paper gives an account of the first two years of analysis of a boy whose poor physical endowment played a central role in the difficulties which brought him to the Hampstead Clinic at the age of eight. Looking more like a pathetic five-year-old, David made a disconcerting initial impression on his interviewers. Small, thin and dressed always in shorts, his pale narrow face was obscured by his thick round pebble-lensed spectacles. The sensitive maturity of his face contrasted oddly with his tiny stature.
In his Diagnostic Profile on David, the psychiatrist painted the picture of a confused, anxious, unhappy child who was nevertheless still fighting on all fronts. He described David's ‘nervous energy, liveliness and wish to be friendly and the remarkable ability he has to reflect upon himself and his objects and to communicate this in a steadily related stream of consciousness’. David was able to evoke a positive and concerned response in both our own psychiatrist and the one who first saw him at his local Child Guidance Clinic.
He was referred for treatment by his school because of his increasingly vicious attacks on other boys. His headmaster reported that David was biting, scratching and pinching. He also hinted that David might be stealing. Subsequent interviews with the parents revealed battling relationships at home and many other problems. He was argumentative, demanding, easily frustrated and liable to fly into violent tempers. He had difficulty in sleeping and was strikingly accident-prone and hospital-seeking. He was often babyish, said he wished he were a girl and enjoyed dressing up in girls' clothing. He had no friends. Mrs. C, his mother, suspected that he was under-achieving at school. In the psychological test, David's attention and concentration were disrupted by his intense anxiety and there were signs of significant neurotic interference with his performance. On the WISC he scored a verbal IQ of 123 and performance IQ of 100. It quickly emerged i