Working in a Neonatal Intensive Care Unit

I met and spoke to Dr. Oliver Lyth once when he interviewed me after I applied to train at the Institute. His interest and gentleness are still with me and made the occasion a moving one for me. Among other topics, this piece of work was discussed and at the end of the meeting Dr. Lyth suggested it should be written up.

Introduction

The work I would like to describe seems to me to deserve the name of applied psychoanalytic work. It is a piece of work in which some insight was gained when I used my feelings and thoughts to understand a certain phenomenon. When I reached that stage I did not “interpret” because that seemed inappropriate for many reasons. I found myself initiating action to try and create a setting in which I hoped some thinking and feeling might be made more available, contained and used, rather than denied or split off. It proved possible to do this with interesting developments that are still continuing some of which I mention in the following.

Four years ago, an unusual referral came to the Child Psychiatry Department where I am employed as a psychotherapist. It was not a child referred by a parent, doctor or psychologist, but a hospital ward referred by the Divisional Nursing Officer in charge of maternity services in the borough. Her letter asking for help for the staff in the intensive care unit was discussed in the Adult Psychiatry Department who turned it down. It then came to Child Psychiatry.

I found myself curious enough to take this request further for two reasons. The first reason was that a large number of children who were referred to our department's special playgroup had been in the intensive care unit as babies. The second “reason” was a child named Russell. Russell was a borderline psychotic 9-year-old when I saw him for psychotherapy four times a week at the Tavistock Clinic eight years ago. In the first few weeks of treatment, the fact that Russell had been a premature baby who had spent the first six w