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.
This is an account of the treatment of a seven-year-old boy with functional megacolon who refused to learn to read or write. The case is presented for its exposition of the relationship between instinctual expression and symbolic expression and of the establishment of the pathway to sublimation that written language represents. The first part of the article deals with the sessions as an ordinary case report. The main interest lies, however, in the second section, in which Czesnowicka attempts to delineate the nonverbal elements that were important in the course of treatment which she considers important in the acquisition of language. Traumata had occurred in the child's life at the time he was acquiring control over both sphincter and language: his mother, involved with a newborn sibling, had been unable to serve as a fixed and stable reference point for the child's sensorimotor development. In treatment, the therapist remained stationary and allowed the child to explore and organize his space. Reading and rereading of stories familiar to the child proved important. The patient gradually progressed from being lulled into comprehension to the utilization of language for communication. He had to accustom himself physically to the space in the room and to the person of the therapist. From a verbal 'bathing' in the sounds of well-known stories, the child advanced to the construction of a space in which sound could be perceived as neither painful nor disruptive. The author relates these difficulties in learning to read and write to the difficulties in spatial organization, including the experienced space of the boy's own body.