Dialogues with Children and Adolescents

A Psychoanalytic Guide

Björn Salomonsson, Majlis Winberg-Salomonsson

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317505570
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Psychoanalytic work with children is popular, but the sophisticated language used in psychoanalytic discourse can be at odds with how children communicate, and how best to communicate with them. Dialogues with Children and Adolescents: A Psychoanalytic Guide shows how these aims can be achieved for the most effective clinical outcome with children from infancy up to late adolescence.

Björn Salomonsson and Majlis Winberg Salomonsson draw on extensive case material which reveals the essence of communication between child and therapist. They enfranchise the patient of all ages as an equal participant in the therapeutic relationship. Presented in letter form the cases contain no professional terms. Only the final chapter contains theoretical commentaries applicable to each case. These terms and theories help to explain a child's behaviour, the analyst's technique and the background to the disorder.

This is new creative development in child therapy and analysis which is written in a very accessible style. Dialogues with Children and Adolescents will be essential reading for beginners in psychoanalytic work with children and will cast a fresh light on such work for more experienced clinicians. It will also appeal to the non-professional lay reader.

Chapter 1

The Land of O

The Land of O can be described as a faraway place, which we have discovered through our psychoanalytic dialogues with children and youngsters. We have already described some of its characteristics: strange, crazy, moving, funny, illogical or just puzzling. Once one embarks on a journey to the Land of O, questions emerge effortlessly: Why does the baby in his pram suddenly start to scream? Why do we witness such a storm of protest from a three-year-old who knows that his waterproof trousers are comfortable in the rain but who nevertheless refuses to put them on? Why do we hear incessant giggling from the ten-year-old girls in the school restroom? And what about the exchange of glances among the fourteen-year-olds when the teacher is strolling across the schoolyard?

In therapy with children, the questions are similar but more complicated. Let us give an example: six-year-old Anthony, whom we will meet in Chapters 13 and 14, is trying in vain to understand why he is so stressed and worried. His family goes on a holiday trip. When he returns to his therapist he says, “We had a great time in England. We took a boat there. You can do that you know – you don’t have to fly. The boat even carried our car and a lot of trucks, too. But before we left, I got the traveller’s fever. Mum explained it to me when I couldn’t fall asleep; it was the night before we started our trip.” He thinks for a while and suddenly bursts out excitedly, “Now I know what I’ve got. I’ve got the traveller’s fever! I’ve got it all the time, and you see what happens. I just can’t sit still on my chair.” Anthony is a hyperactive boy having a hard time focusing on his tasks at school. Now he is describing how he was eagerly and anxiously waiting for the family trip. Suddenly he realizes that he is also describing how he may get anxious in other instances without understanding why. Thanks to his new application of the term “traveller’s fever”, his constant anxiety becomes a little more manageable than before.

Another instance is a teenager’s parent who is met with a cascade of angry outbursts from his or her child, “You damned idiot! You never let me do what I want to do and one day, I bet, you won’t even let me leave home and you’re worse than a dictator and you … !” Catherine rushes into her room. After a while she phones her best friend and has a chat with her for one hour at least. We overhear her saying that a certain boy who has filled her heart and mind for the last few months has recently been treating her badly. In such moments, the incomprehensibility of her angry cascade melts away and we are able to look into some of the innermost feelings concealed beneath it.

Many times a child may seem beyond understanding because we adults try to persuade ourselves that we are so different from our little ones. But actually, we carry the same kinds of emotions that they do even though we handle them in different ways. Let us illustrate: Uno is one year old and he has just learnt to walk. He is immensely proud. But every time he loses his balance and tumbles down, he cries for Mum. She gives him a mug of lemonade but he throws it on the floor. He is in despair and is also ashamed and angry. Falling down on the floor was a catastrophe. After a while he looks at the lemonade, has a sip and shines up. Out of the blue, he forgets everything and starts walking happily again. At this precise moment his mother is thinking about Uno’s grandparent, her father. Towards the end of his life, old Sidney has become paralyzed and now spends his days in a wheelchair. Sid, who used to be quite a sociable fellow, nowadays accepts only occasional visits from his family or friends. He has become depressed because he feels that he has turned into a “vegetable rotting at a retirement home”, as he describes himself. Last week Sid called his daughter to tell her about his dream the night before. “Without any problem whatsoever, I was flying about in the sky, visiting all my children and grandchildren. It didn’t matter much that they are living all around the world! No paralysis any longer and no depression either – at least for the time being.”

Old Sid and young Uno are both struggling with the pain of having lost an ability they thought they had mastered: the ability to walk. The pain and the paralysis “get on my psyche”, as Sid explained to his daughter, but he and his grandson Uno react to this pain in different ways. The following night Sid dreamt that he had been fettered with a heavy chain to a rock. That dream was not as pleasant as the one preceding it. “I guess that’s the way I feel, like Prometheus bound to the rock. I suppose some eagles will come soon and pick me up for good.” Things do not look that way for young Uno. His desperate feelings of some seconds ago are soon forgotten. This is a fellow who lives in the present moment! The next time he falls on the ground he gets up quickly and runs along. Until he falls again …

In the introduction, we suggested that we had more reasons for introducing the letter O when describing the world of children. We also use the circular letter O to represent the infinity of the child’s inner world: Unendlich in German, Oändlig in Swedish. People often grant that children and adults do have the same kinds of feelings. Nevertheless, they are convinced that children’s feelings cannot really be as complicated as those of adults, at least not complicated enough to lead to some of the behaviour they see. So they turn to us, asking, “You are a child therapist. Could you please explain why this child is constantly quarrelling?” The one seeking an explanation may be a parent in a difficult situation at home or a teacher who cannot come to terms with a troublemaker in the classroom. Here is an example of what an adult might tell us: “Every time I talk to Adrian, and I am quite friendly to him, he snaps back, ‘Oh, won’t you just shut up!’ It’s terrible to hear and I just can’t stand it! Tell me, what’s wrong with him?”

Of course, it is provocative and painful to hear words like these from another human being, regardless of his or her age. But people who want a quick explanation for such behaviour often assume that mental life is simpler and more understandable in children than in adults. This is not the case, according to our experience. We often have to answer, “You have just asked a difficult question. I will answer you to the best of my ability, but please do not expect any simple response or quick solutions.” The mental world of the child is as infinite and complicated as that of the adult. It is replete with creative but maybe far-fetched notions, crazy misunderstandings, wild leaps of emotion, morality debates, raging love affairs, passionate hatred, shrewd schemes and artistic conceptions. And for a description of the adolescent’s turmoil we find no better one than Anna Freud’s (1958), which was written half a century ago. She describes,

the anxieties, the height of elation or depth of despair, the quickly rising enthusiasms, the utter hopelessness, the burning – or at other times sterile – intellectual and philosophical preoccupations, the yearning for freedom, the sense of loneliness, the feeling of oppression by the parents, the impotent rages or active hates directed against the adult world, the erotic crushes – whether homosexually or heterosexually directed – the suicidal fantasies, etc.

(P. 260)

The Land of O is thus Oändligt or infinite. Our letter O also relates to the term the Unconscious: das Unbewußte in German, det Omedvetna in Swedish. We would like to explain that term in the following way: when we are working intensively with a child, we observe everything she or he says, draws, plays and dreams. We imagine ourselves as standing outside the child’s O. In this respect, we are like anyone else in front of a child. But we do something more: we try to imagine what is going on inside the ring of the O – that is, in his/her Unconscious. This latter term is not easy to grasp. You cannot put your finger on the Unconscious; you cannot make a blood test to measure it, or take a picture of it in a scanner or with an X-ray. None of us ever seems to be quite comfortable with the fact that we cannot reach these remote corners within ourselves – that is, all our contradictory fantasies, feelings and memories. The Swedish poet Gunnar Ekelöf (1965, p. 144) once expressed it this way: “Every human being is a world, inhabited by blind beings in dark revolt against the I, the King, their master.”

We see and are blind – both at the same time. The Conscious is perhaps not so difficult to describe. But how are we to acknowledge and describe all those thoughts and feelings we knew yesterday but do not remember today, or those we have never quite understood but which nevertheless affect us throughout our lives? We provide a tentative answer via a poetic metaphor by the French author Albert Camus (1994). He compares the unconscious layers of our personality to “those measureless waters under the earth which … have never seen the light of day and yet dimly reflect a light, come from who knows where” (p. 278). Not only are these subterranean layers vast and difficult to fathom. In addition it is only hesitantly that we set out to uncovering them, and the more we approach them the more we tend to close our eyes. It is no wonder that the Delphic Maxim γνῶθι σεαυτόν (gnothi seauton or “know thyself”) is so hard to live by. This also applies to children. They often seem spontaneous and uninhibited, but they, too, have internal recesses that they shun and prefer not to know more about.

So far, we have brought in sources from Sweden, ancient Greece and France to portray the internal world of children, or, as we call it, the Land of O. It is time to bring in a source from another country, the English psychoanalyst W. R. Bion (1970). He used the letter O to denote “ultimate reality, absolute truth, the godhead, the infinite, the thing-in-itself” (p. 26) of our inner world. A renowned scholar in this field, the US psychoanalyst James Grotstein (2008), emphasizes that Bion saw the mind as unfathomable and infinite, and that it depended on the therapist’s so-called negative capability, or his or her tolerance of uncertainty and ambiguity, if he or she could wait outside of O to capture whatever signals might be emitted.

We prefer to compare the relationship between O and the external world – with all its sense impressions and observations – to a permeable cell membrane. There is ceaseless traffic of information passing from the Unconscious, the “measureless waters” or “the Land of O”, through the membrane to reach the person standing outside. As analysts we are waiting outside the child’s “membrane”, and we try to understand the signals to the best of our ability. Sometimes instantly and spontaneously, sometimes only upon lengthy reflection, we may suggest to the child what we envisage he or she is trying to express or is preoccupied with. Only rarely does a child, especially someone who is having emotional difficulties, understand why he or she is jumping about all the time, has nightmares or refuses to put on waterproof trousers when it is time to go to preschool. Nor does he usually understand the origin of his funny ideas and fantastic drawings. “It just came out that way!” Similarly to an adult, a child has an unconscious world which has never seen “the light of day” but which nevertheless is emitting signals across the “cell membrane”. These are the signals that we as analysts try to decipher in order to help the child. In doing this, we contribute to making the dim reflection clearer to him. In these circumstances, he may become able to find words for what has been frightening him, as in the case of young Anthony when he said, “Aha, I’ve got the traveller’s fever!” It was as if this expression opened up a shaft to his “O”. With its help he was now able to better discern what was troubling him, and to express this in words.

Does our cell membrane model imply that the analyst also has unconscious inner notions? Is he or she also an inhabitant of the Land of O? Definitively! Here is our argument: no one would be surprised to learn that curiosity is vital for a psychotherapist. Furthermore, he or she must be persistent and systematic, intuitive and courageous, and must not shy away from embarrassing facts and unpleasant findings. After all, such a relentless and compassionate search for the truth goes for anybody pursuing a scientific effort or, for that matter, anyone wanting to get close to another human being, be it a partner, a friend or a patient in a dialogue. But the psychoanalyst needs another asset as well, that of turning curiosity towards him/herself in order to ask why he or she reacts this or that way with a patient: “Why did I become so moved by this boy right now?” Or: “Why do I find this girl to be so charming at today’s session?” This procedure, when the analyst explores his own personal Land of O, is defined as making use of the countertransference. We use this term to cover the emotional reactions, not least the unconscious ones, of the analyst vis-à-vis the patient. By investigating his or her reactions, the analyst may better understand what is going on inside the patient. Does this sound complicated? We hope it will become clearer as you go along reading the book! Let us go to the letter box and open the first letter.

Chapter 2

The hole in the escalator

Hi there, Björn!

Here’s a letter from someone who visits you at your office and who’s two and a half years old. Aha, you guessed it! Bonnie! Mummy often says that I’m her little sweetie pie. Of course, I like that – but at the same time I don’t like it. I’m sure you understand. Sometimes when I hear it I start to sulk. That’s because I like to think of myself as a cool kid who can be tough and fight for her own way if she wants to. And I can put up a big fuss! But of course I don’t do it all the time.

But never mind all that. I’m writing because I want to tell you something: one day, Mum and I were going somewhere on the underground. I like to ride the underground very much. The wheels of the train screech and click and make all kinds of funny noises. And there are so many kinds of people inside. Yes, even dogs sometimes! The little ones sit in their owners’ laps. That’s cute. I don’t get as afraid as when I see the bigger dogs standing by the exit door. But this thing I want to tell you about now, it happened outside the train, after we had left it.

I’ve been to this underground station many times before but this time, everything was different. When we were about to step onto the escalator, it was gone and, instead, there was a big hole! The escalator wasn’t where it used to be. I saw a lot of men with some hard hats on their heads. They were working there, I reckon! Mummy told me they were going to fix the escalator because it was broken. They had taken it away and now there were machines instead. There was a huge clanking noise so I got really scared and then that big hole, too! I mean the hole where the escalator had been all the other times when I was there with Mum.

I started to cry. Mum took me up into her arms and told me we were going to take the elevator instead. She thought it was the elevator’s fault that I got scared! No, it was the hole that was so terrible. I can’t explain why. Mum asked me if I was afraid of falling down into it. Maybe. I didn’t know. When I went to bed that night I couldn’t go to sleep. Wherever I looked I thought I saw that hole right there gaping at me.

I cried for Mum. She sounded a little annoyed when she answered me. She tends to sound that way when I call out for her. I think it’s because I do that quite often when I’m having a hard time falling asleep. Well, I have to admit I call out for her for many other reasons as well, like when I want some extra toothpaste on my toothbrush because it tastes so good – or when I don’t want to put on my red T-shirt because it’s so ugly. Mum and Dad don’t understand why I care about stuff like that, and they say I’m being bossy and picky.

Yes, they say I cry out too much and that I make trouble for them. Well, maybe so. But the thing is that I’m frightened! It’s like when there was that ghost who dreamt me, just about when I was going to sleep. Then I ran to Mum and Dad, to sleep in their bed. Daddy said, “Oh, no! Not again!” He turned over and fell asleep. Mum said, “Okay, but only this time.” So, she let me sleep next to her. The next morning they seemed to be annoyed with me and, would you believe it, with each other as well! When Daddy spilled some marmalade on his trousers, he looked angrily at Mum and said that it was because of the bad night’s sleep he got. Then they both looked at me. Those looks didn’t feel good.

Ugh! Ghosts and that hole in the escalator. No, I don’t want to think about these things anymore, I really don’t. And you know what? I don’t have time to tell you any more right now. I’m going out to play with Neda. She has just moved into our neighbourhood. She comes from another country and has a funny way of speaking. She’s nice. I think we can be friends.

So long and have a nice day,

Bonnie

Response from Björn

Hello Bonnie!

Thanks for your letter. Here is a letter from me. I’m writing to you from Copenhagen. I’ve just visited a museum there. A museum is a big house where you can look at many paintings and statues. There is an awesome statue here and when I saw it, I instantly thought of you. I am sending you a photo of it. The man who made it is called Christian Lemmerz.

Of course, this statue does not look like you at all. You are a lovely girl with curly hair and brown eyes, nothing like this statue. Why did I think of you? Well, I was thinking about that hole in the escalator that you were telling me about in your letter. Can you see...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Introduction
• 1 The Land of O
• 2 The hole in the escalator
• 3 Why are they doing like that?
• 4 Raging with love
• 5 Here comes Pippi Lundström
• 6 You’ll be deader than dead
• 7 We don’t look into each other’s eyes
• 8 My head is a mess
• 9 Restless and ruthless – or just rootless?
• 10 Letter from the volcano
• 11 That tingling feeling
• 12 No connection
• 13 The first time that I saw you
• 14 The last time that I saw you
• 15 Commentaries on Chapters 2–12
• References
• Index