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In this next case there was a marked clinical change following the therapeutic consultation, and it would appear that this change was more the result of the communication between the boy and myself than of a change of attitude towards the boy in his family. It will be observed that this boy had a preoccupation with water and that eventually he established his identity by going to sea.
I propose to give as far as possible all I know about this case1 in illustration of the way in which one can work in a limited area and in this way avoid the infinite amount of detail which inevitably clutters up a psychotherapeutic treatment. It is this delimitation of the area of operation that makes it possible for a child psychiatrist doing this work to carry a very heavy caseload, whereas the psychotherapist, and in particular the psychoanalyst, works with only a few cases at any one time. It is possible for the child psychiatrist doing this work to be involved in 100 or even 200 on-going cases, and this brings the work into a relationship with social pressure.
It will be understood, as I have repeatedly stated, that in my opinion the basis for the training to do this work is a thorough grounding in long-term psychotherapy of individuals, even psycho-analysis involving daily sessions over a number of years.
| Girl | 16 years. |
| Mark | 12 years. |
| Boy | 8 years. |
| Boy |
Mark was brought to me at the age of 12 years by his parents. The father was a colleague, a member of the university staff. In this case I first saw the two parents together as they wished to get my help in orientating to the problem. Much detail emerged in the usual way of an interview that takes its natural course.
The family was intact. The following significant landmarks in Mark's emotional development were reported: