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The background information given reveals the patient’s adverse experiences and suggests that she is likely to have missed out on early experiences of care and containment. The therapist does not comment on the recent diagnosis of Asperger’s Syndrome, whether or not it seems appropriate. Having read just this one session I am unable to form an opinion with any confidence.
The change of room and the recent visit to the paediatrician seem to feature significantly in the session. The patient communicates powerfully her dislike of discomfort, physical and psychic, and her ways of protecting herself from any such experience. The material suggests that the patient does not have much expectation of being understood or of having another’s thinking mind available to her. There is a pattern of her being in touch with difficult feelings and then retreating, often withdrawing into a state of sensory pleasure. She feels she is alone with her difficult feelings and has to find her own solutions to them.
At the beginning of the session the therapist notices that Abigail’s greeting is awkward. It does not sound as if she is meeting up with someone she knows, or is in doubt about this. What is the focus of Abigail’s interest in Doctor Who? Might it be something familiar which protects her from the full impact of the anxiety of meeting a therapist she is unsure about? Knowing, in some detail, the contents of the pictures might help to understand what is in Abigail’s mind. The therapist is quick to reject the idea that she is referring to her recent meeting with the paediatrician. This might, however, be relevant, something that Abigail is struggling with. (It is always difficult to know what use to make of information about external events, whether it is likely to be helpful in exploring the child’s preoccupations or not.)
Thinking about Doctor Who – he has a human form but is not ordinarily human. His form changes.