The Approach of Brief Conjoint Psychotherapy—A Case of Separation Anxiety

In this paper I would like to describe the treatment of a mother and daughter, together.

As a child psychotherapist, newly trained, working very part-time in the busy, general medicine out-patient clinic of a suburban London hospital, I found myself face to face with the predicament of limited time and resources, combined with medical referrals of patients for specific problems.

I found the demands of this setting conducive to brief work.

As a learning experience, I wanted to attempt to bring psychotherapeutic skills, learned in intensive individual psychotherapy, to bear on the model of conjoint and brief work, undertaken together with a social worker. I undertook to keep clear, in my own mind, that although the approach was different, the basic assumptions inherent in the psychoanalytic process were the same. That is, I saw as central to our work to offer a safe setting in which conflicts and anxieties which are interfering in development can be better understood, in which communications can be recognised, made explicit, and then be taken back, to become a part of the person to whom they belong.

June, aged four, is the third of four children. Her mother contacted the social worker in the hospital because June would not leave her mother at all. Mrs. M. told the social worker, Mrs. Goldberg, that for the last three months June had refused to stay with anyone but her mother. Mrs. M. had tried sending her to playgroup, in order to prepare her beginning school in twelve months, but she refused to stay. At home, things had become intolerable: she reported June would start to cry and scream for no particular reason, or for a petty reason—if the ketchup was on the wrong side of the plate, and then would go on sobbing unconsolably, for three hours or more. The family was feeling tyrannised, as they were all “in terror of setting her off”. In addition, June demanded to wear only a few special clothes which fitted just so—the socks must not sl