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Mentally retarded children are sometimes hemmed in by a sense of “no hope”; and sometimes, too, the helplessness felt within their family becomes part of a spiral wherein this lack of hope threads through the child's inner and outer worlds. Perhaps a part of psychotherapeutic work here is to hold onto enough hope for two, and thus offer a form of auspicious retrieval from that time when the mother's joyful, unspoken, expectations are woven around her newborn baby. Psychotherapy is usually engrossing; maybe it also has to have an element of real pleasure, simply be fun at times, for hope to be accepted back again. This was certainly the case with Nigel, a robust eleven year old with a full scale IQ of 67, who was referrred as a result of his uncontrollable aggression and calculated destructiveness both at home and at school.
Nigel had been born with hypothyroidism, which unfortunately had not been diagnosed sufficiently early for remedial treatment to be attempted. When his condition had been spotted he had a brief period in hospital, just before his first birthday. This was his only separation. His parents had always been caring and supportive of him; but perhaps had slightly over-compensated for the guilt felt about his handicap by not placing the same limits around his behaviour as had been applied to his older brother.
When he had been assessed forspecial education, five years before I saw him, it was noted that he had difficulty in relating to other children, to whom he was often violent without any discernable reason. Everyone appeared to have found him both active and superficially friendly, attention- seeking with adults but at the same time strenuously rejecting any overt display of affection.
Now his school, who had referred him as a last resort, saw Nigel as a “very angry little boy” who spent all his playtime doing nothing but getting into fights with other children. He was literally engaged in indiscriminate assaults all the time, regardless of whether or n