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My aim in this work is to discuss some aspects of the treatment of George, a nine year old boy who has been in care since the age of two and who has not had any continuous mothering or family relationships since that time.
Till fairly recently, children who were so emotionally damaged at such an early age were considered unreachable through psychotherapy, because of their difficulties in accepting any relationships offered to them and the hostility with which they reacted to it. My experience with George is in line with Boston's view when she states that “Interpretative work along psycho-analytic lines is possible with these children, but there are considerable difficulties in coping with the violent feelings which are aroused.” (Boston 1972). Typically, in severely deprived children, these feelings are used to create a hard shell which is used defensively as a protection from further emotional pain.
One of the most difficult aspects of the treatment of these children is the struggle to establish a therapeutic alliance and to gain their trust. This trust has been broken many times by the time they reach treatment.
Before discussing George's background and his therapy, I would like to reflect briefly on the setting in which treatment took place. I treated George in a day school for maladjusted children which he was attending at the time and to which I was attached as the child psychotherapist. I saw him three times a week for two and a half years, and during that time I became acquainted with a number of problems peculiar to treating a child intensively in a school setting.
The first point to consider here is the quality of the relationship between the therapist and the teaching staff. Without close co-operation, no treatment stands any chance of success, on two counts, (a) in these schools teachers fulfill the supportive role that parents or substitute parents would play in the child guidance clinic, and (b) this setting gives a child many opportunities to t