You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This is the unfolding of the case of Mary, a little girl who at three-and-a-half years of age had been admitted to hospital because of a total refusal to eat and severe withdrawal symptoms. I hope to show how her anorexia illness, described by Francis Tustin (1958) as a life and death struggle about growing up, was tied to mother's pathology and how once weekly psychotherapeutic sessions for the child and mother for the past three-and-a-half years helped disentangle some of the knots which they had tied between them.
The work with the child diroughout the period went alongside the work with the mother which was undertaken by two Psychiatric Social Workers at the hospital. I am quite sure that it was our joint effort that helped to clarify so many of the problems between the child and the mother and made possible the progress which has occurred. I shall concentrate on the child's material but I shall relate it to the relevant work with the mother.
I was asked to undertake the treatment for Mary when I started to work at the hospital. It was, however, four months since her admission there and during that period she had been seen by the psychiatric consultant, Dr. King. The little girl had been admitted following five months of progressive introversion and regression at home. There were many somatic pains, she had become totally anorexic and was constipated. She had withdrawn, sitting for the whole of the day huddled in a blanket on a chair. She grimaced frequently, and seemed totally lost in day dreams. She seemed to need to avoid all contact with people. Her sleep was disturbed and she was having severe nightmares. Her doctor was extremely worried about her rapidly deteriorating condition and it was decided to admit her to hospital.
In the children's ward, she presented a picture of a tense, depressed, unresponsive, anorexic child, and she was diagnosed as having a depressive illness. Comparisons were made with adult depressives. It was noted that Mary had moods which h