Dimensionality, identity and security: finding a home through psychoanalysis†

This paper suggests that Meltzer’s understanding of the development of inner space can be thought about in relation to how a state of ‘being at home’ can be impaired through early trauma and developmental failure. It shows how a very young child developed a greater capacity for recognising inner and outer experience and consequently a greater awareness of inner space through intensive psychotherapy. Clinical material is presented in which this two-year-old boy moves from profound disorientation and disconnection, through physical containment and moments of communication, to some shared expression and symbolisation of his preoccupations. The author uses episodes from the psychotherapy to illustrate links between Meltzer’s thoughts on impaired interior dimensionality and a resulting terror of the ‘breaking of surfaces’ with Winnicott’s understanding of the necessary ‘gravitational pull’ of a good internal object and the negative retreat which may be caused by overwhelming anxiety. The paper suggests that a developmental approach to psychotherapy with young children has some technical ramifications which might include physical containment, emphasised attunement, simple observational commentary and developmental interpretation. The relationship between interior and exterior spatial awareness is discussed and brief reference is made to a study of psychotherapy with homeless adults regarding their capacity to make use of a physical home. Finally, Bion’s encouragement to abandon memory and desire is discussed in relation to the need traumatised children may have for environmental hope and hopefulness in the person of their therapist.