Julie—The Treatment of a Case of Developmental Retardation

In this paper I shall present the analytic treatment of a child who was, at age five and a half, severely developmentally retarded. The term "developmental retardation" is used in preference to mental retardation because when she was first referred to the Child Psychiatry Clinic of University Hospital, psychological testing revealed an I.Q. of 84. Therefore, according to current, accepted classificatory systems, she could not be considered intellectually retarded. Nonetheless, at this age, Julie could not speak in full sentences, had achieved no emotional independence, was irresponsible in body management, and was unable to play or get along with other children. All this will be amply demonstrated later.

A great deal has been written, by analytic and nonanalytic investigators alike, on the subject of the psychogenic factors involved in intellectual malfunctioning. However, as is the case in most areas of psychological functioning, Freud was among the first to call our attention to this problem. His first reference to this phenomenon was in 1901 in The Psychopathology of Everyday Life, where he described the dynamics involved in ordinary mistakes in reading, writing, speech, and forgetting. There are many more references to this problem in Freud's early contributions (in 1905), (1911, etc.), but the statements most relevant to the topic of this paper are to be found in Inhibitions, Symptoms and Anxiety(1926), where he characterized learning difficulties either as inhibitions of ego functions or as having the structure of a symptom.