On Making Contact with the Child Patient

Psycho-analytic contact with the child is based on the understanding of his unconscious conflicts. Generally, when once the first correct interpretation of his play has been given, a contact is established which, if sustained by sufficient further interpretation and a really detached attitude on the part of the analyst on every occasion and in every emergency, will carry the child through a long analysis.

The child learns immediately that the analyst's purpose is to help him, and in a way in which people in the home, with all their love and care, cannot help. The analyst knows what the child wants unconsciously (or should know), and though he (or she) never gratifies these desires, or shews affection or even sympathy, once the child has realized this, he will often evince willingness to help in the analytic work, patience in face of the analyst's blindness to the meaning of his play, and a perseverance beside which that of the spider which inspired Robert Bruce to further effort pales.

He is intent on getting the gratifications of his phantasy-life in the analysis, and plays out his phantasies with that in view, but can tolerate the deprivation with which he meets only if the analyst has sufficient understanding of his unconscious needs and can support his anxiety even though extreme. But before this can happen, there is a pre-stage of social contact to be gone through.

The child's attitude towards this first meeting may depend, to some extent, on how he has been prepared for it, and it seems to me important (since the mother-child relationship is so close a one) that the mother's apprehension about the whole proceeding, if it exists, should receive attention first.

Handing a child over to an analyst for three-quarters of an hour daily is a very different matter from taking him to a physician for consultation. The mother (with rare exceptions) is shut out of the analytic room, and, for the sake of the treatment, is given very little information about what goes on th