Self-Observation, Insight, And the Development of “Knowing” in a Child Analysis

The case described in this paper was one of a series of cases examined with regard to the nature of self-observation and insight in the analyses of children. It was chosen for study because it involved a child who not only eschewed self-observation in the initial phases of treatment but also fought against gaining an understanding of herself. While defensive efforts at “not knowing” were greatly reduced by the end of her treatment, it was an open question whether she had achieved a significant understanding of herself; and whether such understanding (“insight”) as did occur figured in her remarkable advances in functioning. Thus, it seemed to be a useful case for considering such issues as: What is ‘insight’ in children? What forms does it take? What fosters its development? How relevant is self-understanding for ensuing psychological change?

An additional reason for this study was to attempt to understand why this child, so antagonistic to the treatment process, had done so well. While considerable understanding had been achieved regarding the nature and origins of her disturbance, much of which figured in the interpretive and reconstructive work of the analysis, it remained unclear, indeed mysterious, as to what specifically had promoted her impressive forward development. A “second look” at her treatment offered the chance to reconsider those particular elements that may have been the therapeutic agents of change.

This presentation is in three parts: (1) A brief background account of the symptom picture, developmental history, and salient issues as these were formulated at termination; (2) a tracing of those instances of self-observation that occurred in this analysis; and (3) some conclusions and hypotheses suggested by this study regarding the facilitation of the ego function of “knowing” and the development of insight.

In this paper the term “insight” refers to an integrative construction by the child of past and present experiences which represents a newly gaine