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There is no doubt that Peggy, with whom I began treatment when she was just four- and-a-half, is one of those children who have been born into and have had to grow up in an almost intolerable environment. To the extent to which I have experienced and have been exposed to the reality of this environment I have often felt upset and helpless, at times angry, sometimes even psychologically battered. On such occasions of upset I had to remind myself that I was able to deal with these experiences as a grownup and at a remove, and that they were not part of my own daily life as they were of Peggy's. How then, I often wondered, was Peggy able to handle and to deal with these experiences and this reality? It was also on such occasions that my protective feelings towards Peggy became very strong. Nothing in her environment is either ‘average’ or ‘expectable’. The problems of this outer world, extreme, uncertain and unreliable, are greater than the problems of her inner world, which without doubt also exist.
During the diagnostic discussion in which Peggy's case was considered, two questions were deliberated at length: one as to Peggy's possible placement; the other as to the aims of her treatment.
The idea of placement was rejected for three main reasons. Firstly, it was felt that the support which Peggy's mother received from various sources, such as the Social Services, the Clinic Nursery, friends and relations, formed an extensive network which would hopefully prove effective in preventing Peggy's being killed. Secondly, it was difficult to envisage at that time how a placement could have been achieved at all without the cooperation of this mother, who, in spite of all her ambivalent feelings towards her child, would in all probability have fought any battle to prevent her child being taken away from her. Thirdly, a separation between the mother and her child was thought likely to prove damaging to Peggy's development. (So far as it had been possible to establish