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Encouraging changes take place in the nine months between these two sessions, recorded in fascinating detail by an obviously sensitive therapist who makes every effort to get in touch with Lizzie. One of the most striking of these changes concerns the growth in Lizzie’s capacity to remember and to make links. In the first reported session, she repeatedly drops objects she has been using as though they no longer existed, or treads on them without seeming to notice. Nine months later, she can go in search of some folded paper from a previous session; the therapist observes her stopping on her way to the therapy room as though for the first time she were remembering something or someone else. This growing internal coherence is quite different from the way children with autism often seem to ‘stick’ themselves to whoever is with them without a backward glance at the person they are leaving. It may be related to Lizzie’s invitation to her therapist to chase her in the corridor before and after the second session – to take upon herself the role of pursuing someone desired and elusive. That would be a request for containment, but would also indicate a budding capacity for play and a growing belief that she was someone who mattered and whom the therapist would make an effort to find.
In this connection, I found myself wondering just how often Lizzie was being seen. Fifty-nine sessions in nine months suggest that she was coming more than weekly, but it would barely cover two appointments a week, even allowing for holidays. Was Lizzie offered two sessions a week or three? The answer affects our view of how much her parents are able to support her in building up a coherent
picture of reliable relationships. If she was offered two weekly sessions, then her parents are supporting her development by bringing her to all of them. If she was offered three, then her progress in keeping things in mind in spite of patc