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Child psychoanalysts are called upon to help with children whose development has often gone markedly off-course. For these youngsters, the usual modes of discussion and interpretation are frequently of limited value at the start of analysis and may only gradually and to a limited extent become the central medium of therapeutic work. For some of these children, play may carry much of the therapeutic task. The creation of the therapeutic space in which playing may unfold, and its utilization in the service of treatment, is the responsibility of the child psychoanalyst. The analyst may also, at times and judiciously, interpret within and outside the play. There are tensions between allowing play to emerge as a therapeutic process in its own right and the usual psychoanalytic emphasis on clarification, verbalization and, above all, interpretation within and about the transference.
Andrew entered psychoanalysis at the age of seven because he was painfully sad, isolated, and increasingly backward in all areas of functioning (Cohen, 1990). For hours, he sat quietly on the floor. At times, he pretended to be a pet dog. He spoke very little at home and hardly at all with teachers or other adults. He was becoming more regressed, now eating only with his hands, and there was little that cheered him up. For three years, from 7 to 10, he was in psychoanalysis. He was again seen for therapy in early adolescence and then during his college years. Recently, he married.
During the course of his childhood analysis, he remained a very quiet youngster, barely speaking at all during long months. In one phase