Chapter Five. Play Observation in a Hospital Setting: Some Diagnostic Implications

The work recorded in this chapter was carried out by Martha Harris with doctors from the Institute of Infant Neuropsychiatry at the University of Milan between 1970 and 1973.1 There are three cases of play observation which were conducted in the hospital by Romana Negri and (in one case) by Laura Musetti; followed by two infant observations which were presented for supervision in the context of the same clinical group. Each of the children in play observation had posed particular problems in terms of diagnostic evaluation.

In psychiatric practice, above all in infant neuropsychiatry, it is quite frequent to encounter symptoms which do not conform unequivocally to any single diagnostic picture but which may belong to quite different and distinct clinical situations. In considering a child's inhibitions, for example, we need to judge whether psychotic or neurotic elements are dominant. The various psychical tests and instrumental examinations used in the traditional clinical approach do not always permit this type of differentiation, so it often happens that the neuropsychiatrist is drawn into abstract theorization, without necessarily realizing it, and so loses sight of the concrete elements that define the meaning of that particular case.