Commentary by a Tavistock-Trained Child and Adolescent Psychotherapist

In the therapist's prefatory remarks to the clinical material the therapist comments that she is not reporting whole sessions but only selected ‘elements’. The reader's attention is drawn to the fact that this is not the full

picture and that there are gaps or missing pieces. The effect of this, in conjunction with the partial or fragmentary selection of material, is frustrating and tantalizing. The editor in her introduction draws attention to a similar feature when she comments on the ‘unadorned’ style of the written word. In the account of the first assessment session the therapist twice comments on the patient not being ‘forthcoming’. There is a similar effect between patient and therapist to that between writer and reader, and we might wonder if something of significance is being reproduced or replicated.

During the first meeting of therapist and patient, the therapist finds herself ‘wondering what moved him emotionally’ and towards the end of this first meeting, though Gregg has told her a number of ‘facts’ about himself, she has ‘no idea what he felt about anything’. It is when she tells him this that there seems to be more of an emotional connection between them - Gregg ‘was really taken with this’ and the therapist's comment leads to mutual recognition and a ‘sense of relief’. Other countertransference experiences which the therapist describes, in subsequent sessions, include feeling ‘cut off’, the ‘painful’ silence, and being ‘sent… into a spin’. Although the therapist does not explicitly state it, she appears to have a recurrent experience of feeling it is difficult to connect with Gregg - even when it seems clear what he might be feeling - and there is a painful sense of being kept at a distance.

The lack of connection with feelings and closeness with other people is a preoccupation and concern of Gregg's. In the second assessment session Gregg returns to the problem: ‘He talked about what it would be like to have feelings about things. How would that ha