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The Silent Child is a substantial collection of papers edited by Jeanne Magagna, a senior child and adolescent psychotherapist who is well known for her writings both on infant observation and the theories of psychoanalysis. In this collection Magagna shares with us the enormous depth of experience and thinking that she has gained over many years of impressive work in the treatment of hospitalized children's deep distress. She also gives us the opportunity to understand how the team of professionals work together at Great Ormond Street Hospital and the Ellern Mede Centre in London, and to know more of the contribution made by disciplines other than psychotherapy. The collection is ‘intended to help parents and professionals compassionately comprehend the child's difficulties in depending on someone to receive their communication’ (p. xix). Many of the young people whose troubles we come closer to in the book are not only not speaking, but also not walking or eating. They have let go of abilities they have once had, some of them clearly being very talented people. The difficulties with living we are asked to think about are severe. Magagna tells us she has worked intensively with 15 such children who have ‘given up on life’.
Running through the book is a debate, which is not explicitly explored, around whether we are thinking about a retreat from life, or a refusal of words, food and movement. A refusal involves a rejection, which a retreat does not. The theoretical implications are important. A refusal emphasizes the active difficulties put in place by