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The theory of psychoanalysis has come to be applied to a large number of treatment modalities since the Second World War. In the introduction to his book, Untying the Knot: Working with Children and Parents, Dr Brafman makes a case for revisiting Donald Winnicott's ideas about the ‘therapeutic intervention’ (1971). He states that his aim is to set out a clinical approach to cases where the referred patient is a child or adolescent, but where the parents are intimately involved in the consultation.
In the second chapter, ‘The clinical encounter’, Brafman considers various issues which arise in the clinical encounter. One has a sense of someone chatting about his work in a relaxed collegiate manner. He is humorous, giving technical tips about how to put children and parents at their ease to get things going: for example, after listening to the child, he turns to the parents and says ‘And who are you?’ This chapter prepares the way for the following three chapters, which give clinical accounts of eleven children aged 13 months to 15 years with varying degrees of parental interaction.
The focus in the initial contact is not to discover the ‘correct facts’, but how the child interprets what is going on around him. His priority is to engage the child in a joint venture to discover the unconscious fantasy or conflict underlying the presenting symptom. The symptom, whether it is headaches, enuresis, constipation or more overtly psychological problems, such as anxieties, phobias or nightmares, may already have received attention from other health professionals to little avail. By the time the child reaches the psychoanalytic consultant, Dr Brafman, he is ready to ‘find’ an object he can communicate with. The consultant occupies the place of the child's ‘subjective object’, as if the child already ‘knows’ him. The encounter with the consultant therefore offers a precious opportunity which can be seized, and something ‘magical’ transpires when the child feels his communication h