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This paper about a child called John has two main purposes: first to study the relation between image and symbol, and second to demonstrate how inner symbolic activity leads to ego growth.
John had exhibited states of violent and often manic excitement for about one year before he was seen at the clinic; in them his sense of reality was so defective that ordinary methods of control, such as restraint and punishment, were not effective away from home; in the end a good nursery school, after many attempts to help him, was compelled to exclude him and refer him for analytic treatment. As a first step before this was begun, he was placed in a small group of children who needed special educational care.
John's mother, a warm-hearted woman, tended to become too permissive in her handling of him because of her guilt at having produced such a child. His father, on the other hand, resented his son's behaviour and being a mixture of bombast and sentimentality was ineffectual when he tried to exert control; his punishments were often violently resented. In spite of these defects the home was good, because both parents loved their child and wanted to keep him at home. They proved to be helpful and reliable in bringing John for treatment, and the preliminary assessment of them was amply confirmed by several years' knowledge of them.
John was four years old when I first saw him and had already been in analytic treatment for about one year before the symbolic process developed, which therefore happened in his fifth year.
Before describing the rather dramatic changes which came about later, it will be valuable to sketch a few events in the child's first year of analysis so that the later ego development can be described against this background experience. The material will also place the synthetic events in their context and