From the Study Group on the Process of Child Analysis

[Editor's note: This article initiates an ongoing column featuring the activities of the Committee on Psychoanalytic Education (COPE) study groups and workshops. COPE's mission is to educate psychoanalytic educators within the American Psychoanalytic Association in all aspects of psychoanalytic education. Members interested in psychoanalytic education and in participation in committee activities should contact the chair of COPE, Robert Michels, rmichels@med.cornell.edu.]

In relating to parents of children in psychoanalysis, the analyst must balance two essential and sometimes opposing demands: the child's need for privacy and the necessary parental support for the treatment. Adding to the complexity of the effort to establish and maintain a balance is the possibility that a child whose disturbance warrants a recommendation for psychoanalytic treatment may live with parents whose sense of privacy, autonomy, and respect for individuality is impaired. The balance between respect for the child's intrapsychic life and the need for parental support is often resolved in favor of the child's privacy, often at the expense of the analysis.

In our review of treatments, those analyses interrupted before accomplishment of optimal work were those in which communication deteriorated between the analyst and parents. The analyst often concluded that the parents had perceived the analyst as competitive and/or a threat to their autonomy. In order to regain control, parents in this situation may see no other course but to end the treatment. In reviewing these situations, many in our group thought a different approach to the parents might have preserved the therapy.

In our review of treatments, those analyses interrupted before accomplishment of optimal work were those in which communication deteriorated between the analyst and parents. The analyst often concluded that the parents had perceived the analyst as competitive and/or a threat to their autonomy. In order to regain control, parents in this situation may see no other course but to end the treatment.

The following examples represent two divergent positions of analysts in our group. An analyst convinced that proper child analytic technique requires minimal contact and interaction with the parents relies on what the child communicates to him, believing that frequent parental contact introduces data that does not come from the child and thus adversely affects the analyst's associations to the child's material. This analyst also believes that frequent contact with the parents intensifies their transference to the analyst. Such transferences may result in interference such as parental competition with the child for the analyst. Since the parent is not in analysis with the child analyst, the analyst's interpretive interventions are limited to the child patient.

In contrast, an analyst convinced that work with parents must go beyond the goal of maintaining the privacy of the child's intrapsychic life acknowledges that parenting is a complex task requiring the development of skills that are vulnerable to interference. Working with parents then includes the task of identifying interferences in parental functioning so that parents can become aware of the interference. Parents are unable to think about how to address such difficulties until they are aware of them. A therapist who helps a parent in this way has not abdicated the role of child analyst to become the therapist of the parent, but may have ensured that the analysis can continue.

In summary, two positions characterize views that define the range of current practice of group members: The first is to have minimal contact and interaction with parents; the other is that the work involves the task of assessing parental functioning, identifying interferences, and helping parents decide how to address these problems. Most child analysts will work pragmatically with an approach somewhere between the two positions. However, such work is possible only if attitudes formed during the analyst's education permit it and the analyst has acquired the necessary technical skills.