"It isn't Fair"—The Treatment of a Blind Child1

Ann's treatment enabled her to develop ego capacities necessary for repression, but this could not be fully accomplished until she was helped to establish better object relations and to be aware of her absence of vision. The awareness of her blindness was a painful and arduous achievement that required years of painstaking work. The treatment promoted the availability of neutralized energies through the therapist becoming a needed love object who was an ally of the child's ego. In this manner the treatment also enabled Ann to develop oedipal longings. Initially, the therapist made contact through an auditory and tactile pathway that established the therapist as an object associated with safety and with libidinal gratifications. Through this attachment the therapist was gradually permitted to provide leadership in organizing the perceptual experiences, especially those dependent upon a visual component. In blind children there is more anxiety because of a lack of visual warning involved in accidents. This danger factor disturbs ego consolidation. Such children need a protecting mother in order that hearing and touching can become useful as a protection.

Following the ideas set down by Freud (1915a), (1915b) in regard to the adaptive function of repression, especially the infantile repression, it occurred to us that Ann's painful memory represented a deficit of two of the ego capacities that are forerunners to the establishment of selective repression. These two forerunners are: (1) a