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The onset of treatment of a 5-year-old boy, following tonsillectomy, was marked by convulsions and a devitalization of his body in catatonic-like state. In the analysis identification with death-dealing guns and machines coincided with 'playing dead' games. Passivity on the part of the analyst precipitated regressive trends while her structuring of the session towards 'playing baby' who was fed and fondled produced an arrest of these symptoms and progressive features. The child first presented her with switches to 'turn off' his schizophrenic activity and later undertook control himself. The identification with the machines was a projection of his aggression and an attempt to control it by immobilizing himself ('playing dead'). Ego functions including integrated speech were given up to maintain this control. Dying was introduced to prevent the acting out of murderous impulses directed against his mother and himself.
At a later stage of the analysis in response to threatened break-up of the family, separation from his mother, and loss of a friendship, the child identified with crippled men and adopted in play the feature of blindness. The machine as a projection of powerful and aggressive bodily structure was replaced by an actual body which experienced separation as damage and destruction, a feature probably related to the experience of separation and tonsillectomy.
At a turning-point in the analysis, the child indulged in an ecstatic and exhausting dance, and said 'For you I would do anything'. Later he wrote, 'I want to live, to live because I love my doctor and she loves me.' The dance represented a revitalization, a primitive overcathexis of the body, which could now be permitted.
The author describes certain parameters in the technique adopted and the account is illustrated with numerous drawings.