Transformations of Anxiety in the Relationship between the Psychotic Child and His Mother

The reflections put forward in this paper are based on a particular type of experience that I gained during many years of parallel therapeutic work with mothers and their psychotic children. Some of these children were “shell-type”, while others were “entangled”, according to the definitions proposed by Tustin (1981).

Some of the same phenomena turned up time and time again during work with different mothers and children. For example, the child during his session would explicitly and unequivocally act out or symbolize the mother's dreams or deepest anxiety; the mother in turn would refer to the same material later, during her own hour of analysis, and the form was always absolutely superimposed. Or again, several of the child's most tenacious symptoms, which had so far resisted every therapeutic effort, would suddenly disappear at the very moment when I was witnessing the emergence in the mother—or at times in the father—of an archaic fragment of the ego upon which the related experience had been inscribed. Still another example was the incredible capacity these children had to use primary process functioning in order to lend form to physical, mental and emotional states that were latent in their parents.

These and similar occurrences led me to focus attention upon several specific characteristics of these mother-child couples. I was particularly interested in the role played by anxiety in determining and maintaining such a relationship, in which the phenomena I have described, and others like them, prevail over relationships and forms of communication based on language and secondary process generally.

The specific questions which sprung to mind were, “Why such a relationship?” Or, “Why do these relationships all have the same peculiar quality of being dominated by experiences that, as one mother put it, seem ‘Larger than life’?”

This paper does not touch upon cases of childhood psychosis that are a reaction to grossly traumatic elements in the initial holdi