Children in clinical psychoanalysis are able to resolve conflicts and move ahead developmentally. This therapeutic process is facilitated by the psychoanalyst's understanding of the child, reflected in multi-faceted and thoughtful clinical technique. We review aspects of the analyses of four developmentally deviant children who were engaged in child psychoanalysis because of ego disturbances that impaired their ability to learn. These clinical analyses are used to exemplify three intertwined processes related to the therapeutic action of child psychoanalysis: therapeutic alliance, transference, and the role of the child analyst as a real person. These processes were expressed in and were influenced by the emergence of particular types of play in which the children explored complex issues in their lives. Along with other aspects of psychoanalytic technique, including interpretation, the analyses of these four children illustrate the therapeutic meanings of play in child psychoanalysis.