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I would like to begin by expressing my gratitude to the clinician contributing the material, for the opportunity to think about such an interesting, difficult session and to be able to discuss it. It gives us an excellent chance to look at the possible causes of violence in children such as these, as well as to reflect on issues of theory and technique surrounding our work with very young children and their parents. This session presents us with an opportunity to see how the work with both the adult and the very young child involved in this sort of therapeutic situation, restricted by its brevity, takes place simultaneously. I say this because I understand the therapist's interventions throughout the session as having a dual purpose: to contain the child's escalating rage and destructiveness and to attempt to explain it to the mother in such a way as to improve, or perhaps create, her capacity to understand her child's behaviour and, through that understanding, enable her to handle it in a more satisfactory and productive manner.
Containing the child's aggression becomes a major feature in Owen's case because, as Anna Freud often reminded us, acting out that does not lead to insight or to change and for which interpretation is not accepted is, of course, not beneficial.
The way in which one talks to such very young children is influenced by some of the main difficulties encountered in such work: the limitations imposed by their capacity to understand what is being said to them, their lack of insight into their abnormalities, the absence of a therapeutic alliance, the immaturity of their ego and, most important of all, the reality that the child's dependency on his parents reduces the possibility of his developing a fully fledged transference to the therapist. This is all very relevant because it colours the way in which one addresses a child. It goes without saying that this is all connected to the way in which one understands whatever the child is showing us: interna