Images of Maternal Holding in Once-Weekly Psychotherapy with Children in Care

This paper aims to give a picture of the difficulties as well as the potential for once-weekly work in the Child Guidance setting with children from a background of early deprivation. Whilst the case material comes from the Child Guidance Clinics where I have my therapy room, materials and long-term commitment to patients, and where I rely on the ongoing support of the rest of the clinic team, the wider setting which has enabled me to work with the children I shall be considering involves a much wider team which goes far beyond the confines of Child Guidance. It includes, in a variety of combinations, the comprehensive circle of care provided by Children's Home staff, Foster Parents, Social Services Social Workers and teachers.

The audacity to embark on once-weekly psychoanalytic psychotherapy with children who have had harrowing early experiences and who lack consistent early care is relatively new. The importance of first establishing a stable, holding network within which to embark on this work will soon emerge from the material. In the past, it has been the experience of workers with a special interest in such children that, because they lack in consistent early care, the establishment of total environmental containment at the level of good primary care is essential. Certainly, it is easy to see the merit of a complete therapeutic and educational setting such as the Mulberry Bush School, where children have an opportunity to re-experience early traumas, losses and unheld states in a safe setting. The staff are attuned to picking up and staying with each child's individual needs and wishes in this area no matter how unbearable the stresses and anxieties evoked. There is an understanding and acceptance that learning as such cannot take place until these ghosts are laid to rest, and infantile preoccupations put in their proper perspective no longer have a life-and-death quality, leaving room enough in the child's inner world for ordinary learning and dev