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That this slim, modest volume has recently been reprinted so soon after its original publication date is testament to the wisdom contained within it and to its worth at a time when more children are experiencing emotional distress and needing professional help than ever before. The variety of different professionals working with children in different settings is now vast and parents seeking help are likely to be confused. Dr Brafman makes the point that the diagnostic evaluation and the subsequent treatment that the child receives will depend entirely on the conceptual framework of the professional who is consulted. His framework is unequivocally psychoanalytic and his book will do much to demystify this approach for parents, and for those working in child and adolescent mental health. It describes in everyday language how psychoanalytic thinking can help us to understand children's emotional difficulties. It is an application of psychoanalysis to the often necessarily brief encounters with young children and their parents, that typically occur in child guidance settings. Dr Brafman is concerned with the impact of early experience, and with unconscious fantasy upon the internal world of the child, and he aims to create understanding at a deep level which can produce change. Such change is made possible by the child's wish for help, conveyed by his presence and by the symptom which is troubling him and from which he seeks relief.
The knot is a word borrowed from Winnicott, who used it to describe an impediment, an obstacle occurring against the background of normal development. Brafman draws extensively on Winnicott's writings about consultations with children. Where he differs from Winnicott is in seeing the knot as an entanglement in which parents and child are caught up together, as the interaction between them somehow compounds the problem. This can happen when a parent's anxious response to their child is determined by unconscious factors belonging to their own e