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This account set me thinking along a number of possible trains of thought. Inevitably, I wondered if the father and/or any other siblings were around. I also wondered if mother was receiving any support and what about the school – did they need work to help them understand or manage Abigail better? This springs, I think, from wanting to try and both understand the context for Abigail and to maximise the chances of her improvement. But in the absence of this information, we turn to the session write up.
What we do have is a very brief history. Abigail is 11 years old, her mother probably had perinatal depression, and was depressed ‘during her infancy’. Abigail has been sexually abused. She has recently been moved to a hospital school, presumably having started in mainstream at five years old. She has recently been diagnosed with Asperger’s Syndrome.
The combination of a depressed mother and the sexual abuse is not uncommon. Abigail’s early experience of her mother may have been a ‘blank face’ mother, or she may have had a mother who projected her despair or rage, unprocessed, into baby Abigail. In neither case would Abigail’s early fears and phantasies have become processed by a containing mother. It seems likely that Abigail had to hold herself together, to process her own, and her mother’s terrors, and her own internal containing capacity developed only somewhat, and perhaps not at all.
The sexual abuse is not surprising; sadly Abigail must have been a vulnerable, needy child who could easily be encouraged into an abusive relationship. It seems no one was really holding her in mind if the abuse went on for two years before it was stopped. The emotional impact of this abuse, with the penetration of the body boundary, and the possible threats or violence, came on top of her early deprivation.
How does all this present in the session? The early comments abou