Clinical Commentary by a Kleinian Child, Adolescent and Adult Psychotherapist

This clinical material belongs to the initial stages of the psychotherapy treatment of a 7-year-old girl. All we know about her is her age, the fact that she is the third of four children, and a reference made by herself about inconsolable crying, abdominal pains and the refusal to attend some classes.

Natalie seemed to come into the consulting room easily. She is described as a slight child', which probably refers to her build, but maybe also about a way to enter situations trying not to take too much space. Hesitant when she comes in, she appears to the psychotherapist to be relieved when she is invited to sit down on a child's chair. It brings to mind that, for Natalie, there is a relief in being allowed to be a child; not to have to take care of anybody or make decisions herself. In her drawing the frame seems to be important. I thought that the picture expressed her need to have a context within which she could be a child that could nourish and grow into a chair that is too big at the moment. It may be a reference to something in herself that requires to be fed so that she can learn. Something in pain, unattended, that contributes to a level of anorexia. She is a hungry girl in a tracksuit, which hints at a certain sexual ambiguity, perhaps a desire to be a boy.

Natalie seems surprised, ‘uncertain’, when she hears the interpretation. I think that in these first moments of the session she has projected what she hopes this new relationship could provide for her - to satisfy her need of nourishment. The psychotherapist does not pause over this as long as I would have done and chooses to refer to the reason for being there, and the possible likely meaning of the abdominal pains.

For myself, the presence of the big chair led to the thought that Natalie may feel that she has been given a role that she is too small to fulfil; involving taking care of herself