The Never Land — Loss of an Idealized Pre-Birth Place and the Gain of a Thinking Mind

This paper describes the main themes in the psychotherapy of a severely epileptic girl, over a period of eleven years, aged 16 at the time of writing. For most of the therapy the girl lacked an ability to differentiate between herself and others, and therefore there was little development of rudimentary Oedipal conflicts. Her severe physical and mental impairments were inextricably linked to this fundamental problem in the process of separating: the physical problems compounding the emotional, and the emotional compounding the physical. Her mother's illnesses were significant factors. Throughout the girl's life she was subject to extreme medical interventions. The paper draws upon psychoanalytic models of mind and body integration, including notions of the ‘biopsychosocial dysregulation’ model of illness. The clinical material describes the girl's use of the dolls to populate a Peter Pan Never Land, with its many static perspectives, denying growth and the difference between the generations, although therein was the beginning of the use of symbolization. As the child's awareness of her physical impairments grew, so did her despair at her own and her mother's hopeless physical condition. However, she became more able to express her outrage, but with the life-saving awareness of a therapist who was not also ill. This led to the girl's increased ability to acknowledge differentiation between self and other, further painful awareness of her disabilities, losses and possible death, as well as those of her ill mother and, gradually, an ability to acknowledge the passing of time and an appreciation therein of a healthy separate thinking part of her that could use symbolization and allow for some separateness and some emotional growth.