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This sensitive and very readable book on the psychological experience of the child with a life-threatening illness is written by a Canadian psychologist. She describes her work as ‘psychotherapy’. She clearly is very experienced in working with children with cancer and other life-threatening conditions, and approaches this inevitably painful subject delicately yet confidently, using a wealth of short examples of clinical material which vividly illustrate the points she is making. In this slim book Sourkes usefully breaks down the subject into ‘Psychotherapy’, ‘Illness and Treatment’, ‘Impact on Normal Life’, ‘Facets of Awareness’, ‘Anticipatory Grief, and ‘The Dying Child’. There are many line drawings by children and some colour plates. The fact that there is no index is a serious drawback in using the book.
I feel that overall this book is limited by the sparsity of psychoanalytic understanding - the only psychoanalytic author quoted is Winnicott (who is frequently and helpfully used, particularly in understanding play). Thus many of her observations lack depth and insight. For example, Sourkes simplistically writes about the child's relationship with medical caregivers, briefly describing their responses ranging from terror to trust, and concludes with ‘However, most children are eventually able to integrate the staff's caring with the necessary infliction of pain that treatment involves’ (p. 44). Although earlier she explores the possible fantasy of ‘illness as punishment’, her cognitive Piagetian perspective of concrete thinking explains only one aspect of the situation. Her discourse is impoverished by the lack of reference to the realms of unconscious fantasy, the internal and external relationship with the mother/father, previous negotiations of trauma, the resurgence of infantile aggression, persecution, splitting, projection, and so on. Similarly, Sourkes's definition of psychic trauma is a quote from the child psychiatrist, Ten (p. 4). Neither Sourkes nor