You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This clinical extract raises many important issues for the child psychotherapist working with seriously ill children in hospital.
My countertransference to the first paragraph was to feel shock at the self-destructiveness of Guillain–Barré syndrome: how, like a cancer, the body's immune system attacks part of the nervous system. Furthermore, I was struck by how much uncertainty about the prognosis must surround Maya and her family. And I wondered why Maya's dramatic illness happened just at the point of her achieving academic success. But I realised that to think psychogenically was unhelpful, especially as this is not a ‘neurotic’ illness as far as we know.
At the beginning of the first session, the therapist acknowledges to Maya the length of time that she has been in hospital, summarises the worrying physical symptoms and succinctly refers to the timing of the onset of illness in the young girl's life. This ‘introduction’ by the psychotherapist is helpful, because it relieves the patient, who is already debilitated, of having to tell the story. It leads to Maya then
offering an account of the alarming onset of symptoms. As Maya's story unfolds, she talks lucidly about her own earlier thoughts that it was ‘all in her head’. There appears to follow a sympathetic emotional engagement between the therapist and Maya, where the latter acknowledges the therapist's comment on how hard it was at the beginning really to believe in this experience, but adds that already she is in touch with the awful reality. At the point at which Maya says that she is focusing on trying to get better, she trails off, saying she is thirsty.
I wondered if Maya's enormous physical and emotional effort ‘to get better’ at times feels too much, if she has doubts about her capacity to overcome this illness. It is probably too early in the contact – after all, this is early in the first meeting – for the therapist to voice these sorts of thoughts, but I found mys