Treatment of a Child with Severe Ego Restriction in a Therapeutic Nursery1

We selected the case of Bobby Y. for presentation, as an addition to our clinical knowledge of children with severe ego disturbance; and as a demonstration of what can and cannot be done for such children in a nursery setting.

Mr. and Mrs. Y. applied for help with their four-and-a-half-year-old son, Bobby, who was afraid to leave his mother out of sight and frightened of all changes. He followed her around from room to room, "wearing himself out." On the playground he sat by her side and could not be induced to play with other children or to ride off on his bike. His father could persuade him to ride his bike, but he would turn around and look back frequently. He was easily startled by the ringing of the doorbell, and by his little sister's crying at night, which would wake him and cause him to vomit. The parents dated onset of his disturbance to the illness and death of the maternal grandmother, when Bobby was three years old. She had had several heart attacks and had to be hospitalized each time and there had been much excitement and weeping. Bobby had to be hushed and carried around every time he cried so as not to disturb his grandmother. She had lived with them from the time of Bobby's birth and had been very devoted to him and he to her, so much so that they could not bear to tell him that she died. Bobby asked for her frequently and they told him that she went away and would not come back. Now he seems to have forgotten her. To make matters worse, two weeks after the death of the grandmother, Mrs. Y. left suddenly for the hospital to deliver a premature