Clinical Observations on A Borderline Psychotic Child

This case has been selected because it shows how a great deal of interesting material can be communicated to the therapist by a child although he does not speak.

David, aged eight, was referred for treatment because he spoke to no one except to his parents and because he was not learning at school.

He lives a quiet life, the only child of parents who are themselves emotionally disturbed and who are both extremely worried about his lack of progress. His father is self-centred, immature, anxious and domineering. He always has to be early for engagements and bursts into rages if kept waiting. He tells David to pull up his socks and stop being foolish. A favourite opening to a remark is—“When I was your age …”. The father's “jokes” are a source of anxiety to the child whose grasp of reality is already slender. For example, he will suggest that David should go out to his work while he goes to David's school. The mother is not allowed to tell her husband her worries about David because he has work to do and his sleep must not be disturbed. The mother is an extremely anxious woman who finds it difficult to speak to strangers. She is tormented by feelings of guilt and she can think of no joy she has ever had in the upbringing of David. She is sensitive, timid and at times very unhappy in her relations with her difficult husband. She says that she knows what David is feeling and that she suffers with him. She sometimes even finds herself performing his odd actions such as biting the back of her hand.

According to his mother David was a contented, thriving baby though shy and soft-hearted. At two weeks he had to have painful drops put into his eyes and his mother found it easiest to do this while he was at the breast. He was a very forceful sucker and had “mad rages” when he would bite the nipples and after the milk gave out at three months, he would bite the teat of his bottle. It was some time before a suitable food was found for him and meantime he suffe