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This is a collection of papers by staff and graduates of the Tavistock Child Psychotherapy Training, plus a paper by Genevieve Haag. Ten of the papers describe extended psychoanalytic work with very disturbed children, in each case giving a picture of the whole course of treatment of a child with detailed material describing major themes and moments. Papers by Maria Rhode and Haag each group together some of their work with different children. There is a very full account by Sue Reid of one session with a child. There are four mainly theoretical discussion/overview chapters (by Alex Dubinsky, Alex and Helene Dubinsky, Maria Rhode and Margaret Rustin). There is a theoretical glossary by Rhode, and an Introduction and a Postscript to the whole collection by Rustin. The volume both presents a good deal of clinical work and sets out to draw general and theoretical themes from it.
The accumulation of accounts of individual children is clinically rich and often moving. Some of those papers which offer accounts of the whole course of the work with a child—a style of paper much loved by child psychotherapists—are especially moving in the intimate sense they give of these prolonged, deep, shaping encounters. The best of these papers both bring considerable understanding to bear, and, at the same time, communicate a sense of the full weight and shock of these often immensely difficult contacts, where strong but distressing attachments form. In many of these papers, it is made clear that, while some of the impact of these encounters was well grasped by theory, some parts of what took place altogether eluded understanding. In her clinical paper, Rustin addresses directly and courageously the difficulty involved in facing the limits to her understanding and helpfulness at the end of the very long process of therapy with one child.
The overall form of the book is that of a dialogue between chapters that are mainly theory and chapters that are mainly clinical. The mainly theoretical