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In Live Company, Anne Alvarez discusses a wide range of issues, from autism and its treatment, which is the main focus, to the factors which positively or adversely affect the development of a child, to her presentation of the findings of developmental research and her investigation of various points of psychoanalytic theory and technique. The basic structure of the book, what actually holds it together, and does it well, is the clinical expertise from which the author brings forth her considerations about the needs, the difficulties, the challenges and the rewards that psychotherapeutic work with very ill children demands and offers. It is an interesting book, well informed on the most recent developments of research and stimulating in its presentation of alternative psychodynamic points of view.
The Live Company discussed in the book is the sense of human presence which seems to be missing in some very severely autistic children. The title of the book is taken from a poem by Colin Trevarthen, and presented in a quotation ending: 'In the rhythmical vitality of movement is the first identification of live company'. Alvarez argues convincingly that mother and infant are the first live company for each other. Live Company is also the psychotherapeutic treatment, where the therapist has to maintain herself alive as a therapist, and not succumb to the lure of repetitive pseudo-interpretations unchallenged by theory which has become stale in the process. Alvarez does not idealise the psychotherapeutic treatment that is possible with such extremely difficult patients and her detailed discussion of the difficulties and pitfalls would be valuable to anyone working analytically with patients, autistic or otherwise; the emergence of signs of life in her patient is convincingly described.
Anne Alvarez is a child psychotherapist who has