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[This section is a regular feature. A short piece of clinical material from an actual session is presented with a brief introduction about the case. The material has been sent ‘blind’ to three people who represent different psychotherapeutic schools of thought. They have been asked to comment on the material and the approach of the therapist in the session. The intention is to put these commentaries on the same material side by side for comparison of the different approaches and to facilitate the understanding of alternative terminologies and modes of practice - Ed]
The therapist writes:
F is a six-year-old boy, younger son by many years of wealthy business parents. He was left in the care of frequently changing nannies and au pairs from five days of age. His mother had been worried about him since she was told during pregnancy that he had a small head. F had been intensively investigated and no physical handicap had been found. F was referred by the parents for exposing himself and spitting at home and at school, which resulted in difficulties in finding education for him. The parents were worried that he would not be able to go into the family business.
F was assessed for psychotherapy and was offered four times weekly therapy. The session presented took place nine months into the therapy, on a Monday, after a missed Friday. Unknown to the therapist F's latest nanny had just left.
F came ten minutes early with Don, a new escort - a gentle older man. He encouraged F to come when F ignored me. ‘Look, I've got short sleeves.’ F stroked his arms and approached me with both hands as if to touch me.
By the lifts F looks at Don and then at me, saying ‘Mother-Fucker, shit’, etc. He looks back at Don as if to demonstrate his abusive relationship with me. He smiles to Don as he goes on swearing at me and Don tells him gently to stop. He is still smiling as he goes into the room in the wrong direction and smiles in a lively way as I point him the right way t