Clinical material

Background

Eve is one of five children who were all taken into care following a history of domestic violence, physical abuse and neglect. Eve’s mother is physically well although she suffers from depression. No information is known about Eve’s birth father. Until her removal at the age of four and half, Eve lived with her mother and stepfather and four other siblings: three younger and one older than she was. Eve was born at term, a good weight, with no neonatal problems. She has remained physically well and achieved her developmental milestones with respect to gross and fine motor skills, but there were some concerns about Eve’s language, social and emotional development. Her speech was slow to develop. At three years of age, Eve was noted to have bruising on her face and body. Eve was reviewed again a few months later when she sustained other scratches and bruises on her body and face. This led to a Child Protection investigation and her removal from home.

Eve’s first placement was with two of her siblings. This lasted only 10 months. Eve formed a close relationship to her foster carer but had to move to a second placement to separate her from her siblings. She lived in this second placement for 11 months. She was then placed with her then prospective adoptive mother, a single adopter, at the age of six. She started to attend a local mainstream primary school in Year One where she displayed indiscriminate behaviour and was described as difficult to control and overly friendly to strangers. In the classroom, she had difficulties managing in group situations as well as keeping focused on tasks required of her. Classroom support needed to be funded for her.

Eve’s referral came to our team via her GP. Because of her reactiveness and inability to stay in the room without the presence of her mother during the sessions, the therapist who assessed her had doubts as to whether Eve would be able to work in a one-to-one psychoanalytic setting. The decision was made, however, to