Commentary by a Kleinian Child Psychotherapist

I am impressed by the enormous emotional impact of this session with F. The brief description of his history is extremely painful to read, and aspects of it seem to be brought vividly alive in the session.

While I believe that, theoretically, the therapist and I might be in agreement about the meaning of this little boy's material, there are some points where I disagree with her. I should also like to look at some important technical questions in interpreting to such a vulnerable and fragile child patient. Consideration of technique, however, is a different matter in examining a session after the event, especially somebody else's session! In the heat of the moment, in a therapy room, with a patient like F, a Child Psychotherapist has a very different task from colleagues who work with adults. Examination of the transference, and of one's countertransference, may be hindered while one is avoiding hard missiles, accurately aimed, considering the physical safety of the patient, and contemplating the ‘big mess’ which must later be cleaned up. Literally!

The beginning of the session, in the waiting room, by the lifts and getting to the therapy room, reveals the patient's state of mind and the transference after a longerthan-usual weekend break. F seems to be in projective identification with the kind of man, or father, whose contempt for women and their weekend sexual behaviour shows no pain. He is facing in the wrong direction and may have in mind his absent therapist who is seen as the bad, sexual mother who turns her back on her children. (In the transference the therapist is, in Bion's words, the personification of the bad object, present and persecuting, for the patient, made bad by his aggressive projections and fury/horror at being separated from her.) His identification also seems to include the idea that other men (Don) share this view of weekend-women. Nonetheless there is a hint of something else. F is easily turned in the right direction by the therapist and sh