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I.Child Analysis Today. Esther Bick. Pp. 328-332.
II.The Ego's Participation in the Therapeutic Alliance. Liselotte Frankl and Ilse Hellman. Pp. 333-337.
Contributions to Discussion. Pp. 338-343.
Bick considers the slow growth of child analysis; the attempts to understand this problem; the differences between adult and child analysis from the viewpoints of student and practicing analyst; and the stresses and gratifications, both external and internal.
External stresses include financial difficulties, time consideration, and the difficulty in finding parents who will bring the child five times a week over a period of years.
Internal stresses are: the therapist's anxieties over his feelings about communicating with children; taking responsibility; conflicting with parents' expectations; and specific countertransference problems. Bick feels that countertransference stresses are more severe in the analysis of children than of adults because of the child's greater dependence, his positive and negative transference, and the primitive nature of his fantasies. The child analyst must depend more on his own unconscious to provide clues to the meaning of the play and nonverbal communication. The strain in bearing the child's suffering is intensified because of the appeal to the analyst's parental feeling.
The child analyst has to provide both an external and internal atmosphere in which the patient can re-experience irrational infantile and childhood relationships. The student analyst should do his child training while he himself is in treatment because the anxieties aroused will help to deepen his own analysis.
Frankl and Hellman point out that the child analyst must evaluate carefully the ego's relations to both the inner and the outer world. This determines his interpretation as well as his timing and formulation. The analyst's understanding of the child's need to defend himself helps to develop a confidential relationship in which the child will want to share with his