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edited by Jeanne Magagna, London, Karnac, 2012, 366 pp., £39.99, ISBN-13: 978-1-85575-518-5
… if we listen attentively
we shall hear a faint flutter of wings
the gentle stirring of life
and hope.
(Camus, 1960)
These words lead the reader to the serious realm of silent communication where the child is not communicating with words, often not even eating or walking, for long periods of time. Nevertheless by attending to the minute details of the child’s behaviour, a sensitive observer sees that the child has not stopped communicating with his/her body. However faintly, the communication goes on. The authors of this very inspiring book write vividly about their slow and patient work, based on skilful observation, with children who have no wish to communicate verbally and they consider the challenges faced in reaching these withdrawn patients. These closed-up children and adolescents have ‘pervasively retreated from life’. The authors prefer to use this term despite the fact that the young people may have been given a diagnosis of ‘pervasive
refusal syndrome’. They strongly feel that it may mislead the family, the child and professionals to think that the child has a choice about whether to refuse or to retreat, arguing instead that s/he feels terrified and is retreating from unbearable external or internal emotionally or physically turbulent situations. As Jeanne Magagna puts it, ‘The child gives up and retreats into non-thinking and not-talking in the context of family relationships. The extreme behaviour of withdrawn children, who have given up hope, reflects intergenerational silences, family silences, and the child’s dissociations, withdrawal from unbearable pain, and retreat from ‘family secrets’’(p. 124).
The book starts with an introduction to the theme and explores the possible origins, in young children and in adolescents, of a retreat to a state of emotionally unreachable non-thinking. In early infancy, for example, there may have been a too painful situation when