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This presentation will attempt to focus on the way in which an acrimonious marriage (and subsequent divorce) affected the development of a disturbed latency girl, Sara, who clung increasingly to pathological defences of a phobic and obsessional kind. Before concentrating, in the analytic work, on the defences which underlay these symptoms, considerable time had to be spent in helping Sara unravel her confusion deriving from the highly disturbed relationship between her parents. This required work with the parents in order to understand better the nature of their interactions and to gain their support for treatment. These interventions threw light on Sara's defensive identifications with her parents and allowed her and the therapist to work on the phobic and obsessional symptoms that were truly her own. Because the work proceeded in this way, the following account concentrates on the disturbance within the family and subsequently outlines the developmental history and the clues it provided for the reconstructive and interpretative work.
Sara was in therapy with me for three and a half years, having begun intensive treatment at our Clinic at 8 years 9 months. The original referral was to a child guidance centre a year earlier. Her problems were longstanding but her mother was being made desperate by the panic in the child, who was unable to be alone by day or night and needed Mrs C to sleep near her. She performed curious rituals, frantically touching things around her and then putting her hands to her mouth. She complained of having ‘germs in her mind’. Sometimes she would threaten to kill herself by making as though to jump out of a window or by running into the road.
Mrs C's deepest concern, however, was that Sara had mood swings from violent fury to despair, ‘like those of an alcoholic’. At the time of referral we did not fully appreciate the serious effect that the father's drinking had had on this child.
When Sara was first interviewed at the child guidance centre