Psychotherapy of Childhood Psychosis*

Therapy means healing. Once the prerogative of priests, then, for two thousand years, of doctors, it has in the recent past became the privilege of all—truly a therapeutic explosion. Three such healers stand in front of you this afternoon: a psychologist, a teacher—and a doctor. We are all psychotherapists in the sense that we use non-physical methods, but clearly such a wide definition has become meaningless. Psychotherapy is a method of psychological treatment based on psychodynamic principles, such as the existence of the unconscious, of mental mechanisms such as repression and identification. My quarrel with this definition is not that it is wrong, but that it is too narrow and incomplete. This definition does not include the contribution it will have to accept from others, for instance teachers and psychologists, nor does it recognise the great influence psychodynamic thinking has made and will make upon the other disciplines.

Up to, say, the late 1940s, there has been little published on this subject. Since then a wealth of literature has appeared: on individual therapy, combined therapy with parents and children, group therapy with children and psychodynamically oriented management of residential places which can justifiably be included here.

It should not surprise anyone that the picture that emerges from all this work is not a unified one, that the methods used vary, that the theoretical approaches, though many of them are subsumed under the heading of psychoanalytic theory, show almost as many differences as similarities.

The reasons for this are obvious. The whole approach is relatively new: results—successes or failures—have to be measured after years of effort; the conditions under which treatment is given vary widely; and many problems that are specific to the treatment of psychotic children are, as yet, ill understood. An attempt to assess the value of psychotherapy of psychotic children on the basis of the published work strikes me as a futile undertaki