Initiating and Developing a Psychoanalytic Approach to Children*

A description is given of issues encountered in providing a psychoanalytic approach to supervision of individual therapeutic work with children where this was not previously available. Using examples from supervision and treatment, I describe ways in which the manifestations of transference and countertransference can be explained and shown to be useful clinically. The anxiety generated in giving up previous approaches and developing new ones has to be contained in supervision, particularly when therapists are working with seriously damaged children in poorly-resourced services. With specific reference to children, two issues are highlighted: (a) the potential for ‘developmental resonance’ between the child's/adolescent's situation and the trainee/trainer dyad which may lead to enactment in supervision; and (b) the relatively common occurrence of therapy not developing beyond the stage of mutual idealisation’. For some children this may be sufficient but it is suggested that for those with more severe difficulties this may compound their problems. This is highlighted as an area which requires further research in relation to choice of therapists and assessment for therapy. A detailed description is given of a supervision which is functioning well and facilitating therapy. Reference is also made to the experience of becoming a supervisor, with particular emphasis on the need to re-negotiate ‘the capacity to be alone’ as described by Winnicott.

Initiating and developing a psychoanalytical approach to children is a complicated process which makes considerable demands on both supervisor and supervisee. The benefits of attempting it are seen in the developmental opportunities which accrue to the supervisor, supervisee and children with whom they are involved.