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As Jeanne Magagna writes in the very last page of her book, this is ‘the work of my lifetime’. It is a deeply personal book, one in which Jeanne asks questions about herself and her desire to work with children who have so dramatically withdrawn from life and from hope. It is also a fascinating compendium of her many years of clinical work at intensive special units, with patients who seemed beyond reach and beyond help. The reader can see Jeanne at work, using her body, her heart and soul, to be emotionally present to her very disturbed patients.
I worked with Jeanne at Great Ormond Street Hospital over 20 years ago, and I still vividly remember her style both with the patients and the hospital staff; her empathy and compassion, and her capacity to apply complex psychoanalytic ideas in an incisive yet unthreatening way. I remember her ability to stay on the side of hope, even when the patient was barricading against any possibility to think or understand emotional states which were difficult to bear for the young person, their parents and family, as well as for the paediatric nurses on the ward.
The recurrent theme of the book is reflected in its title: ‘ways to release the imprisoned self’. In the first chapter of the book, Jeanne sets the scene, starting from infant observation - another skill that she mastered so beautifully and taught to many students around the world. How does a mother listen to a silent baby? How does she contain the baby’s most primitive anxieties, Bion’s ‘nameless dread’ (Bion, 1962)? When the mother is absent, the baby feels unsafe, therefore it uses the body (mouth, eyes, muscles) to hold itself together in order not to fall apart. This is the beginning of the ‘imprisoned self’: if ‘the bridge to mother is broken’ (p. 26), the infant has to manage emotional experiences which are terrifying; its vulnerable self has to be hidden away and layers of defences will be created in the years to come.
In the following chapters, Jeanne approaches compl