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Child Psychotherapist Child and Family Psychiatric Clinics, Watford and Hemel Hempstead, Herts.
“Human kind Cannot bear very much reality. Time past and time future What might have been and what has been Point to one end, which is always present”.
In one respect particularly today's conditions of work for the child psychotherapist in clinic or hospital resemble those of Freud's earliest psychoanalytic practice. As with Freud's first patients, referral is often consequent on some major traumatic experience. Parents do not habitually seek our help with the general aim of facilitating emotional growth or overcoming some intrapsychic blockage, unless this registers in fairly marked and disturbing symptoms. Their request is usually explicit—to remove some palpable complaint or redress the effects of some environmental failure. Whatever the justice of these frequent parental expectations, the incidence of such cases should perhaps prompt us to reconsider the actual effects of real trauma, and its bearing on our theory and practice. The present paper is a small contribution to such a reappraisal.
Despite the prevalence in our daily practice of such types of referral as I have just mentioned, it is arguable that the notion of “trauma” plays generally a less prominent role in psychoanalytic discourse than was the case, say, fifty years ago. Perhaps this change has resulted from a shift in the clinical interests of psychoanalysts from exclusive concern with the neuroses towards the much more extended field of the “character disorders”, depression, and psychosis, which have increasingly become the focus of technical refinements. On a theoretical level too, the growing emphasis on the earliest phases of maturation and their implications for subsequent psychic development, the rise of “object relations” theory, the stress on the importance of the mother/child bond, have all tended to demote or at least to obscure the importance originally accorded