Editorial

Two articles in this issue are on the psychotherapy of children. They come from very different areas of work, but raise similar questions. Robin Balbernie reports a brave attempt to tackle the unpromising - an ESN head-banger. He confides that his reasons were spurious and require an apology. Such an apologetic stance seemed to fit with the patient's own assessment of himself. The outcome was that odd paradox, in which optimism comes from sticking with the sense of defeat and hopelessness. In view of the good outcome, were the reasons for taking on the case as spurious as the author implies? What are valid reasons? And what countertransference feelings should a psychotherapist allow himself to be persuaded by?

Dean Eyreinvestigates several points of intervention. He begins by countering the claim that the hyperactive child has suffered brain damage. In his paper he shows that the child is ‘damaged’ by maternal depression or anxiety. Interestingly he reports both a child who is hyperactive and an adult who was hyperactive as a child. He concludes that once it is realised that the maternal problem needs investigation, it is possible to offer brief psychotherapy by taking the mother's own difficulties seriously. He has found that this point of intervention can afford rapid relief of the child's problems. Here is a confident assertion about the most favourable point of intervention, and it is backed by the evidence of solid clinical work - work with the mother rather than the child.

How confidently can we take another psychotherapist's conclusions? Inevitably this Journal is thrown back to pondering differences between different approaches.

Jeremy Holmes' article extends Rycroft's view of psychoanalysis as a theory of semantics, a biological theory of meaning. He distinguishes two modes of mental activity which might be employed by psychotherapists. We may think scientifically about the object of our interest as a material mechanism; or we may attempt to engage with our pa