Clinical material

Background

Abigail, aged 11, is being seen once weekly for psychotherapy. Abigail’s mother was depressed during her infancy and Abigail then suffered sexual abuse by an older boy between the ages of seven and nine. By the time of the session presented below Abigail was no longer in mainstream school having been transferred to a hospital school due to her behavioural and emotional difficulties. Prior to this session, there had been a planned change of therapy room as I had agreed to meet nearer the family home (in a community hospital) due to transport problems for the family. This session, 28, is the second in the new setting. I was also aware that since I had last seen her, Abigail had been diagnosed with Asperger’s Syndrome by a paediatrician. This doctor reported that during his assessment Abigail had put a bag on her head and barked like a dog whilst retreating under the desk.

Session 28

As usual, Abigail arrived at her session on time. Mother was sitting next to her in the waiting room – they sat in silence, with mother looking typically weary and worried. On seeing me Abigail got up and greeted me awkwardly. She was holding two pictures in her hand, saying ‘the Doctor’ (she has a particular interest in the Doctor Who television series). At first, my mind turned to her recent assessment and I thought she was referring to the paediatrician – but on looking at the pictures, I could see that she meant Doctor Who. I commented on how good her drawings were.

Abigail then walked beside me, pictures clasped in hand. It was a short distance from the waiting room, through double doors to the therapy room. Abigail spoke constantly about Doctor Who as she walked …

Once in the therapy room, I sat in my chair as Abigail remained standing. Rummaging through her pockets, she produced Doctor Who cards. Abigail held them up to my face, turning them and telling me they changed shape as they moved in the light. She then went to her box telling me her teacher had given