You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Escalona reports on seventeen psychotic children, so diagnosed by the children's division of the Menninger Clinic. Their symptomatology included speech disorders, circular and autistic logic, bizarre preoccupations, low frustration tolerance, excessive fantasying and a lack of integrative capacity. Escalona found that all these children had been to some extent atypical and disturbed since earliest infancy. They showed either exceptional remoteness or irritability or both toward their mothers who felt puzzled by the children from the beginning. In many instances the maternal attitudes seemed to be entirely adequate but the child's reactions eventually caused some pathological behavior in the parent. These findings contradict our usual conception of the etiology of emotional problems in children.
In treating these patients two different types of therapy were used. Some children were treated with the usual psychoanalytic approach in that they were permitted to develop a strong relationship to the therapist which then made past traumatic events and unconscious material accessible so that they could be interpreted to the child. Another method of treatment might be called suppressive, in that it discouraged the expression and acting out of fantasies and provided gratification only in more realistic pursuits. This treatment was only possible when a positive transference was maintained and here the transference was not interpreted. Escalona found that neither approach was entirely successful. The children treated by the expressive type of therapy gained insight, but either failed to change or would relapse as soon as therapy was terminated. With suppressive therapy some clinical improvement could also be obtained, but the underlying psychotic process