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Philip was referred to the Child and Family Psychiatric Clinic when he was three-and-a-half. In this paper I will concentrate on three important patterns to do with Philip's state of being at the time of referral:
Extreme sensitivity to inner and outer sensations linked to a feeling of extreme vulnerability and fragility and a need for things to be “just right”. This vulnerability, in time was heightened by a feeling of persecution from his own desire to break and spoil.
Entanglement with his mother and all his objects, which often took the form of sticking onto (like glue) or sticking into (like pins).
Use of words (symbols) in a precocious yet concrete way, making words into protective devices and into a private language.
I will argue that these three are all related to his underlying anxiety and go deeper than his three year old oedipal fears and feelings (e.g. comparing his penis — which he called a ‘spout’ — to his father's and to his younger brother's). He did have a particular reason to be anxious about his penis however, as he had undescended testicles and knew he would at some time have to have an operation to correct this.
I will try to show how therapy enabled him to feel safe and take the risks involved in growing up, without resorting to these defensive manoeuvres. It is important to note that these patterns, which may also be seen in autistic or psychotic children, were able to be touched and changed, and growth towards health to occur.
I will discuss how this was achieved partly by Philip's ability to regress to infantile feelings and behaviour (as if he “knew” what he needed) and then use his appropriate intelligence and imagination to integrate the regression. Here his use of words was helpful and not pathological. There was a strong impulse toward love, trust and growth in him and his family, and one of the joys of therapy and later follow-up was watching this impetus grow and develop.
I will use clinical material, especially from early and fi