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As my contribution to this symposium, I would like to bring excerpts from the analysis of a young girl who was born with a congenitally deformed and blind left eye.3
In presenting this material I want to stress an apparent paradox. On the one hand this little girl's deformity became involved in every stage of her development, making her psychological growth truly different and more complex. On the other hand her analysis helped her most by enabling her to delineate and restrict her difference from others to just the sightlessness of her left eye, restoring her self-esteem by limiting her damage to its proper reality proportions. It is possible that from understanding this apparent paradox two very simple, practical suggestions may emerge about the management of the young child with a congenital anomaly or with a severe bodily illness.
Jacobson's paper, "The Exceptions, An Elaboration of Freud's Character Study" (1959), is quite applicable here. Although physically afflicted, my little patient suffered most from being treated as different, as the exception who could do no wrong, somewhat in the manner of the truly beautiful women whom Jacobson describes.
Cindy's parents came to me ostensibly to seek advice about discussing the sightless eye with their daughter who was then nearly 3½ years old. Preliminary interviews with the parents revealed that the congenital abnormality had aroused everyone's most neurotic reactions. The eye, for example, had never been mentioned to the little girl, despite the parents having observed her before a mirror passing her hand alternately over each of her eyes. Instead, Cindy had been treated like a little princess whose every wish was to be granted. Requests for a cigarette-holder like her mother's, real lipstick, a stove that really cooked had all been met.
In her enormous guilt the mother often abdicated her maternal role. She allowed Cindy to make decisions that should only have been hers, such as about choice of cur