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The thoughts I am presenting in this paper are derived from my experience with an asthmatic girl who has been in once-weekly psychotherapy over a period of six years.
Jane was referred at the age of seven-and-a-half by the Paediatric Department of a children's hospital. At fourteen, she is now a tall, slender girl with a pleasing appearance and manner. She is the eldest in a family of two girls and two boys. There are close links with grandparents and many aunts and uncles.
The asthma commenced when Jane was two-and-a-half and coincided with the birth of a baby sister. The condition grew worse when, at four, Jane was sent with her sister to grandparents with whom she stayed for eight months. The parents were making plans to emigrate, though these did not materialise. Sometimes the asthmatic attacks were acute, and Jane had consultations at a number of hospitals. She had frequent attacks at night and about four wheezy mornings a week. Eventually she was referred for psychiatric investigation.
Jane was taken on for once-weekly therapy by a psychiatrist, and transferred to me after five months when the psychiatrist left the department. During the six years of therapy there have been two lengthy breaks, one of a year (when I had a baby) and one of two-and-a-half months. In addition to her psychotherapy, Jane has been prescribed Intal capsules used with an inhaler; these are meant to be used prophylactically three times a day.
Jane's birth was normal. On the second day her mother developed cystitis and had to be nursed in isolation. She fed Jane for three weeks only, as the milk ceased. Jane was toilet-trained by father by the age of one. When she was eighteen months, mother miscarried and was in hospital for five weeks. Jane was looked after at this time by the maternal grandmother and a maternal aunt who lived with Jane's parents. Another brief separation from mother came at two-and-a-half with the birth of the next baby. Jane was said not to have shown jealous