A Technical Problem in the Treatment of the Infant Patient

Very young children do not come to us for treatment, they are brought. More correctly, a mother and child come to a clinic because of some difficulty. The fact that neither know at all fully what is the matter will not surprise the psycho-analyst, the fact that the pædiatrician, or his co-workers, treats the matter as one of maladjustment between two people, mother and child, seldom surprises the mother; the puzzle begins when the situation is viewed theoretically. Put briefly the question is 'When does a person begin to be "self-contained"?' or viewed more administratively 'when is "the patient" attending a clinic one person and not (however small the unit) a "social aggregate"?' Such questions are raised by the following cases.

Anna at eight months could not be taken on 'buses or trams because she would start to cry and get into such a panic that her parents could not stand it. This had been going on since the age of five months. Here there was a young, gentle, happy mother with a comfortable home. For some reason I asked this mother how she travelled; she suddenly went very pink and said that she had never been able to go on 'buses up to the time when she left school, she used to feel so bad that she actually vomited. I did not attempt to analyse or try in any way to understand what lay behind the mother's problem. All we did was to discuss it openly and see how it must have happened that when Anna first started to cry on the 'bus, it seemed to have 'touched off' her own forgotten, early panic so that she was thrown out of gear and was unable to comfort the child. After we had linked the two things she began to see just how she had handled Anna on the 'bus. She would, for example, attempt to divert her attention, talk to her, make her think of something else and so on—for all the world behaving as if there really were something to be afraid of (as in her own unconscious, of course, there was). Some time later the mother told me that, after our last tal