Deprivation Entangled and Disentangled

In recent years the plight of abused and severely deprived children has come far more into both professional and public awareness. Increased recognition and improvements in response have occurred, although serious and considerable pitfalls remain (). However, the provision of suitable alternative homes and treatment, including psychotherapy, for those who require these remains scarce and problematic. In the United Kingdom, psychotherapy services for children are poor: there are few trained Child Psychotherapists and their distribution leaves large areas of the country without any at all (Association of Child Psychotherapy 1989). Training in psychoanalytic psychotherapy short of a full training is also scarce (Royal College of Psychiatrists, in press). Providing therapeutic treatment for children will require two steps: an increase in the number of therapists and a movement outwards from established centres. The latter will ensure that individuals move away from their previous professional institutions to develop a culture in which therapy can be carried out, and to provide such therapy.

This paper describes some of the experiences and issues which have arisen for me in the treatment of a severely deprived young boy who was my first psychotherapy patient on moving from my training institution to take up the post of Consultant Child Psychiatrist in another part of the country. In relation to the child, this has been a process of helping him to develop new ways of viewing the world and his relationships, giving up some of the ways which had resulted from his own severe deprivation and which had only served to perpetuate his emotional isolation. For me, part of the process has been the negotiation of an experience of loss (of the previous psychoanalytic culture) along what can be considered “a normal professional developmental path”. The process has been one of attempting to create and maintain an environment conducive to psychotherapy within the physical set