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It would be impossible to overestimate the importance of words and talking in psychoanalysis. After all, Anna O. called her treatment with Breuer “the talking cure” years before Freud even coined the term. And “the fundamental rule” (Freud 1913)—the request that the patient tell the analyst everything that conies to his mind—is still, with only minor variations, the cornerstone of analytic technique. Even the use of play in child analysis is only an adaptation to the particular ways in which children talk, for play is used by the analyst in exactly the same way as the verbal communications of an adult. Indeed, play can be far more expressive than adult language, and the literature on child analysis consists almost exclusively of cases in which children express themselves quite eloquently through their play.
And yet, it is not uncommon to see children who can hardly express themselves at all, either through words or play. Once in the office, they often have even less of an idea of why they might have been brought to treatment than the rather vague notions that children usually have, and they are unable to explain what they might want out of it. They may not be completely non-verbal, but even concrete object-oriented questions appear to present difficulties for them; they often respond with a single word, or even silence. Their play is devoid of imagination and lacking in any substantial theme or content. Although the child may express some recognizable feeling or fantasy in his play, it tends to remain empty and undeveloped.
Of course, periods of withdrawal and empty play are not uncommon in the analysis of any child. But what is most distinctive