Guest Editorial

This issue of the Bulletin is dedicated to diagnosis in child psychoanalysis. This is an area that often causes considerable unease in the clinician, in part because of the complexity of the task. It is not sufficient for the psychoanalyst to make a symptom-diagnosis as this gives little information about the child's inner world or the possibilities for treatment. However, to penetrate further requires the ability to hold together and integrate a number of different paradigms. Phenomenology, developmental processes, biological capacities and constraints, family systems, etc., all need to be considered in conjunction with an understanding of the child's inner dynamics.

The authors here address some of these issues. Viviane Green's paper emphasizes the importance of the developmental perspective and the implicit and explicit assumptions on which this rests; it also considers normal and abnormal developmental processes and how both must be taken account of.

The paper by Karen Solms and Duncan McLean exemplifies the possibility of integrating biological and dynamic perspectives in assessing a particular developmental problem - in this case, that of language delay. This demonstrates the importance of both the neuropsychological and psychoanalytic perspectives for formulating coherent treatment goals.

In an age when psychiatry increasingly uses structured and semi-structured interviews in the pursuit of reliability in diagnosis, Elizabeth Model's paper demonstrates the importance of the unstructured psychoanalytic interview both in contacting and in exploring the child's inner experience.

Lastly, Clifford Yorke's paper argues that metapsychology, or a theory of the mind, is an indispensable tool in diagnosis. It affords a coherent and overarching understanding of the child's functioning which prevents the diagnostic process degenerating into an arbitrary collection of clinical observations.