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THIS PAPER DEMONSTRATES the rapid remission of the severe symptomatology of an eight and a half year old child, which can be attributed to intensive psychotherapy and to a special hospital environment in which each member of the staff took particular professional interest in the case. Due to their cooperation and understanding, the child's transference responses developed toward several nurses according to the changing phases of his therapy. Therefore the child had an opportunity to shift the emphases of his everchanging transference reactions from the figure of the therapist to other persons as well.
At the request of the parents I visited their son Jimmy, age eight and one-half, on the pediatric ward of one of New York's teaching hospitals. I found the child curled up, in a fetal position, in a wheelchair. Since he did not use his hands, the wheelchair had to be moved by the staff. He claimed that he could not walk and that he was blind. He soiled and wet himself and had to be spoon-fed by the nurses. His barking cough disturbed the whole ward. He groaned and moaned constantly and complained about his terrible pain in a whining voice. There were no abnormal neurological findings, and the tentative diagnosis was childhood psychosis.
The parents agreed to have him transferred, under my care, to the child psychiatry ward of the hospital. They gave the following history.
The patient was the middle child of upper-middle-class parents. His sister Mary, ten years his senior, hated him from the moment he was born. During his first year she dislocated his arm by twisting it. On another occasion, she pushed his carriage off the curb, and