Clinical Commentary by a Child and Adolescent Psychotherapist Trained at the Anna Freud Centre

In making any comment on this session with Leyla, it is important first of all to take into account the context in which it has occurred and to acknowledge the considerable amount of therapeutic work that has already taken place over a period of 3 years. At the time of referral, Leyla presented a very disturbing clinical picture. She and her family were seen initially for 3 months in family work, followed by individual sessions ‘taken up with the traumatic impact of Leyla's experience’. She continued in individual psychotherapy in varying degrees of intensity. We of course do not know what went on in all of this work but we can imagine the challenge that was set for the therapist in meeting a young adolescent whose dispossessed family had undergone such extraordinarily harsh and frightening experiences of intimidation and humiliation. Questions immediately arise in my mind about the meaning of such experiences for Leyla - what had she witnessed and gone through and what had been left unresolved in her path as a growing young woman in adolescence in this society?

These and other questions cannot be answered through reading this one session, although inevitably I find myself looking for one or two possible clues. To some extent, I find them - for it is possible to gain some sense of Leyla's underlying concerns about loss, impermanence and uncertainty through listening to the therapist's sensitive responses to the material e.g. Leyla's fears of being tricked, ignored, things changing behind her back without her knowing. No doubt, these responses allude to familiar themes worked through in earlier work. Nevertheless, I find it difficult to draw much of a picture from this session of the power of Leyla's past experiences or, more particularly, of her adolescent life. My overall impression of the session is of a piece of therapeutic activity that is part of an ongoing process working well enough within its own momentum but curiously lacking in engagement with the urgency o