Psychotherapy with a Boy from a Children's Home

In this paper I should like to describe some aspects of the treatment of a boy “in care” who has been deprived of family relationships and continuous mothering at least since his second year of life.

As is well known, such children, whose experiences of parent figures have been so unfortunate and unreliable, tend to be difficult to make contact with and to respond with suspicion and hostility when a new relationship is offered. Bowlby (1946) suggested that such experiences may lead to the development of a delinquent character unless treatment is undertaken at a very early age. Many writers have stressed the damage to emotional and intellectual development caused by early deprivations in the relationship with the mother (e.g., Burlingham, D. and Freud, A. (1944), Williams, Jessie M. (1961)). Williams (1961), pointed out that damage to personality growth may be sufficiently serious to prevent successful foster home placement. Residential care may have to be provided either because of continuing environmental deprivation or as an attempted solution for the difficulties which have already arisen. Winnicott (1956, 1965) suggests that in some cases placement may be necessary before psychotherapy or psycho-analysis can be considered. These children certainly present considerable problems in residential care (Tod, 1968) and the question of what kind of therapy is appropriate and possible becomes an urgent one. Once-weekly psychotherapy is often thought to be difficult, with a doubtful outcome (Yeo, 1960) and has sometimes been found to increase the problems in the home (Brill & Thomas, 1964). Dockar-Drysdale (1968) considers that certain “frozen” children who have never had the experience of loving someone else as a separate person are not ready for psycho-analytic work with interpretations in the transference but need first to be provided with “primary experience”.

My experience with the child to be discussed (who was possibly not “frozen” in Mrs. Dockar-Drysdale