Runways, Control Towers, and Squiggles: The Creation of Shared Moments in the Treatment of Children in States of Psychic Retreat

A review of the literature on child therapy indicates a predominant focus on treatment issues and techniques for children who either internalize or externalize their conflicts. Children who experience themselves as damaged, ineffective, and fearful are seen as internalizers, while children who project their conflicts outwards, via aggressive, impulsive, or oppositional acts are seen as externalizers (Anthony and Gilpin 1976, 1981; Chethik 1989). Very little, however, has been written about children who fit neither of these two broad categories, who instead are in a state of emotional paralysis and appear very withdrawn and disconnected. In the therapy room, such children seem frozen and petrified and find neither safety nor pleasure.

These children can be conceptualized as being in a state of psychic retreat, a term that was introduced by Steiner (1993) to describe individuals who have withdrawn from contact with a bad internalized object and a harsh, persecutory reality. It is a state of disengagement that provides a false and precarious sense of psychic equilibrium and temporary relief from a reality that cannot be faced nor processed. Yet, as Steiner remarks, this relief is obtained at the cost of isolation and stagnation, and the children that I have observed appear to experience their state of withdrawal and isolation as painful and alienating. In the process, learning, thinking, curiosity, and development suffer, and experiences and perceptions become fragmented and disorganized. The retreat from contact and from reality that characterizes the child's adaptation offers a “protective shell” (Tustin 1972) against bad internal objects and against intense paranoid and depressive anxieties. It is a state where emotions are suspended, knowing is denied, and events and experiences become devoid of meaning. Ironically, the child's disengagement perpetuates the failure that it is experiencing in its life and deprives it of understanding. Devoid of meaningful