“Surrogate Refusal”: The Patient's Resistance to The Analyst as Parent Substitute

I would like to begin with a clinical example.

Some years ago while working at an outpatient clinic I was presented with a rather gruesome case. It was that of a four-year-old girl, A, who had recently been showing symptoms of withdrawal and depression following the imprisonment of her father. What made matters especially complicated was that the father had been incarcerated because he had sodomized A's seven-year-old sister, and subsequently had attempted to kill A's mother by shooting her in the head (she lost an eye in the incident). It was not known whether the father had sodomized A, though the mother thought it unlikely.

With such a history, I was not at all surprised when A refused to be alone with me in the office. Nor was I surprised when during the play therapy I became the focus of her negative feelings. A game she frequently played was to cook an imaginary meal and then distribute it. She and her mother would get the good dishes and I would get the leftovers, usually with a heavy dose of pepper, occasionally with a dose of poison. During these sessions she could scarcely bring herself to look at me, and for the most part clung to her mother.

A continued this pattern for several months, though in separate sessions with the mother I was informed that A's withdrawal from her friends had diminished and she was eating and sleeping better. I began to wonder why A had not warmed up to me. In fact, she seemed to treat me with increasing coolness as time went on, and occasionally began to protest against coming. Why was she maintaining, even intensifying, her resistance? The clue came when in one of our separate sessions A's mother revealed that A had begun to ask a good deal about