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This paper describes the first year of analysis of Timothy L., an eight-year-old boy. The impact of life-long, repeated and ongoing environmental stress has put considerable strain on his development. Although he has successfully negotiated earlier phases of development, analysis has revealed the difficulty he has in resolving phallic-oedipal conflicts and moving securely into latency. The fact that his parents are permanently separated and that father makes irregular visits from Italy exacerbates his problem since, in relation to his father, he does not have the opportunity for reality-testing that would be available to a boy in an intact family. This gives him more scope for fantasy. His absent father is both highly idealised and intensely feared as a powerful, castrating figure. Simultaneously, there is the added reality that father actually left and Timothy has his mother to himself. Father's absence leaves him without a safeguard against his intense oedipal wishes towards his mother. The result is that he feels acutely anxious, guilty and fearful of punishment for his triumph. Because father continues to come and go, this situation is continually revived. Timothy's oedipal conflicts remain uppermost and wide open. His preoccupation with father's visits also pose a technical problem in the analysis. It makes the reconstruction of other significant experiences more difficult.
Mrs L. approached the Clinic on the recommendation of an Italian psychiatrist whom she had known in Milan. She said that she had moved back to England primarily to give Timothy the chance to be analysed. About a year before, Timothy, who had been a relatively normal child, fell from a window, suffered a fractured skull and almost died. Although there was no evidence of brain damage, he became subdued, clinging and dependent. A few months later he began primary school in Milan. After two months he was moved to a class for immature or slow children and the school recommended special education.