Comments on “Little Jeremy's Struggle”1

By using a diminutive in the title of his paper (1), Eduardo Prado de Oliviera poignantly evokes the essence of a fascinating clinical story. Jeremy is a very little fellow to be required to carry the heavy projected burden of what the author calls the psychoses of his parents and extended multigenerational family. He is literally immobilized or deadened by the assault of contradictory parental attributions, silenced because of his inability to contain and articulate his experience, and left to thrash about in the throes of movements, gestures and sounds whose meanings are unknown to him or to those who observe him.

As readers we are privileged to be admitted to the consulting room of a sensitive, intuitive, skillful, creative clinician, who not only survived the alienation, rejection and assault initiated by Jeremy and his parents, but made a space for these people to begin to exist as rational beings. Within that space he helped Jeremy to develop a mind of his own so that he might begin to think and then to speak. In the first hour the four year old Jeremy acted as though he were alone in the room, demonstrated bizarre gait and posture, and in lieu of speech uttered strange twittering sounds. Five years later he was able to talk with his therapist about himself in relation to his parents. Granted that maturational changes in language and in self-development must have played a part, without Prado de Oliveira's remarkable intervention such development would never have occurred. Here are a few of the many things that impressed me about Prado de Oliviera's creative approach. He encouraged his little patient to “pay” (take responsibility) for his treatment. He flexibly involved Jeremy's parents, both separately and in the boy's presence, by accepting mother's intrusiveness and turning it to useful purposes and by including Jeremy's absent and rejecting father, first in words and then in fact. He introduced speech as a potential way of comprehending and relating. He meta