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In our diagnostic and therapeutic work at the Anna Freud Centre, we have, for many years, distinguished between neurotic and developmental disturbances. This paper was presented to initiate a series of clinical and theoretical discussions to be held in the Spring Term, 1995, the aim of which is to examine these differences, and conceptualize the ways in which we approach the developmental problems encountered in our patients.
We use the concepts of developmental disturbance and developmental help a lot, but we are still struggling to define it. We all think we know what developmental help is, and why we do it, but we don't actually have it properly conceptualized. So I was glad of the opportunity to look at the history of Anna Freud's thinking and to consider what she meant by these concepts.
My generation of students studied with Anna Freud as her later thinking was developing. We learnt a great deal from discussions with her, but I have not always found it easy to match this kind of personal learning with what we find in her written formulations. I don't know whether others share my experience: that you believe you understand Anna Freud's view, but when you go to her written work, you do not actually find it spelled out. You certainly don't find case discussions, except in the books on technique and defences covering the discussion with Anna Freud led by Joe Sandler (J. Sandler et al., 1980; J. Sandler with Anna Freud, 1985).
I have been trying to consider how the concepts have developed. When I was a student and a fairly new therapist, we all knew about the earlier controversial discussions, the very passionate dispute about the need for an introductory phase; whether children developed transference similar to adults; whether children's play can substitute for verbal free association; whether symbolic interpretation can substitute for the