An Analysis of a Developmentally Delayed Young Girl: Coordinating Analytic and Developmental Processes

Clinical material is presented from a multi-year treatment of a five- year-old girl with a variety of developmental interferences, making it necessary to consider whether standard technique would suffice. History includes the fact that she was adopted five days after birth and told as early as possible about her adoption; she was placed in a restrictive brace from four months to twenty months because of congenital hip displasia. Sandy's ability to let in the outside world was limited by her intense denial, not looking, not taking in, and by her detachment. Her passivity—whether a defense (modeled on her experience of physical restraint) or an arrest—was a formidable obstacle to the development of active transference moments. I use this case as an opportunity to look at the role of developmental sequences in the context of the analytic process. While I consciously did not do anything different than I

would with any child analytic patient, I intuitively stressed certain kinds of interventions.