The Child Speaking to Us

Dr med. Jean-Philippe Dubois
 

While working with a child, an adult analyst will translate into fairly simple words the imaginary psychic operations that operate in the material of the sessions.

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With the use of interpretation, which he was able to do with dreams, Freudian slips, memories, and wit, Freud tackled questions of position, anxiety, and other expressive modalities of symptoms in a boy that he called “Little Hans”. But afterwards, Freud readily recognized that he had learned much about the unconscious and analysis, from observation of feelings, words, or activities of this child, even if the overview of the material was essentially provided second-hand by the parents of the child. Freud also conceded, that as observers, he himself and his interlocutors could have influenced the object and the situation that was observed, as far as the interpretation of the presented material. However, the possibility of interpreting the collected data and information never seemed hindered by the conditions and complications that could have been involved in their collection, or leeched off it. Similarly, Winnicot repeatedly acknowledged a large lack of regard for the input of his patients, both young and old, for understanding psychic data, however archaic.

Furthermore, Freud would say on several occasions, "the unconscious is infantile". But neither of these psychologists moved on from this single observation.  Therefore, what happened, psychically, regarding the child is most often revealed through interpretation, so that the child would come to take a more or less comfortable position with himself and his relatives. Thus, observation simply came to be most often used to confirm that which clinical analysis was able to prove.

What we learn in therapy thus most frequently involves observation through listening. But listening to a child doesn't adhere to the same rules, especially technical, but also interpretative, as those that govern listening to an adult in therapy. Establishing a framework is not done in the same manner, nor within the same constraints. With the child, the invitation to free associate is more so confined to an invitation to dramatize, either by games or images, which is less easy to ritualize than the "say what comes to mind" employed with adults. The actions of a child are implicated just as much as the words. Words are therefore closer to things. We work less with associative words related to thought and more with role play through games or sketches similar to waking dreams or personificative drawings. A certain associativity can definitely be found in these drawings, but combined with forms of reality, creativity, and fiction. All of it can also be subject to interpretation, but in a way that is closer to how an adult's dreams are received during a therapy session. The fact that the material, as spontaneous as it may be, can engage motor function as much as words, positions the listening process differently. 

This all can move very quickly with the child. The situation is often less calm than in an adult's therapy session, and the participation of the analysist during games or role play exercises is required. Simply being a "listener" in wait is generally impossible, and the attention cannot be allowed to truly "float". We don't benefit from the same distance and "secondary process" in this situation. The representations put forth by the child often unfold in immediate events. A certain tension can sometimes focus the attention given to the forthcoming material. Therefore, with the child, we often come to wonder what he wanted to put into the scene or action, even before asking ourselves what he was trying to say implicitly.

Therein lies a unique complication related to role play through analysis with the child. The fact that the parents participate in the initial stages is something separate - which could become a form of resistance to the process, even if certain biographical or environmental aspects can be made use of, as well as an incidental approach to the first objects, which an adult's therapy cannot make use of directly. 

We thus note, as far as the process goes, that for a child, an adult's presence will be informative and based on evidence, and establish transferential data and its usage. The analyst can thus more quickly become a type of parent figure. The analyst may be counter-transferentially confronted with the positions and analogous representations that they had let go of to become an "adult", even if the presence of a child persists in them latently, which the analyst should have already confronted within themself.  

Another aspect of the particularities of analytic work with a child seems to hinge on the fact that it deals with a child in an ongoing maturation process - not truly stabilized as it can be claimed after puberty. When integrating the material brought forth by the child, the analyst must be attentive to "the here and now" of the child's development of thought and their relational modalities as a function of their age. On this basis, the two protagonists' ability to mutually view each other and pretend that the relationship and the exchange remains, in this case, significant.

An analyst’s knowledge of classical child development, or their own theories about it, will support their work. The theories of S. Freud, M. Klein and Winnicott, however they may agree with each other on certain points, sometimes diverge in other aspects of psychic maturation. The perspectives from which they would build the stages of a child’s psychic development are particularly different. One is concerned with the motor functions relating to erogenous zones (from the era of the first topic), or with forms of narcissism set into motion by developing the self (from the era of the second topic). The other relates to fantasy scenarios as points of reference for unconscious thought. The third of these psychic positions of the self originate from care, interactions with others, and separation. There is different interpretative data for each option. The "Three Essays on the Theory of Sexuality" by Freud, and a good number of Winnicott's articles can be read as veritable proposals of constructions that could take place, as unconscious events for the self and thoughts, even without storage in the memory or psyche. What remains most shocking is that the material brought forth by a child can seem to reveal a more Freudian, Kleinian, or Winnicottian perspective sometimes: the material that they present will seem to be brought to life by fantasy, erogenous, or identificatory figurations for the self, which is still integrating. From that point, interpretation could relate to identificatory or narcissistic development as much as it could relate to urges. From this data, the child will psychically mobilize themself during the session.

In the same vein, we remark that they child's symptoms come more easily than the adult's, with respect to expression of fixation in development. In this respect, they themself might be (the symptom) at the root, or the object of an almost direct interpretation. With the child, elements of reality are closer to their experiences which follow. One speaks differently when one has more life to live ahead of them, rather than behind them. Similarly, unconscious data rises to the surface of consciousness more directly, with less resistance, erasure, or complications due to additional defensive elements, even if they may still be active. Consequently, it is still somewhat difficult with children to explore temporality or duration. The state of regression cannot be the same, as the levels remain close to each other. We stay more willingly in the general feeling of immediacy. Moreover, the child themself appears to be confronted with a form of permanent, uneasy strangeness. The familiar is most often restricted for them in the milieu and environment in which they evolve and change every day.

With a child, the analyst will be able to identify more easily the psychic processes that appear in the material that the child brings forth (identifications, fantasies, positions...) in the terms which come up most often from imagination, or simple representations stated in somewhat direct wording. Interpretation will therefore be particularly closer to constructions, the psychic functioning of the child, or the self, in and of itself, that is still integrating, or not yet sufficiently stabilized so that it can be viewed from a distance or put in perspective in the long run. We know that a child's thoughts develop in a more immediate context, rather than a more spread out one. After the fact, these ideas are still quite legitimate with regards to child analysis.

About a decade ago, a quite solitary child with a bit of an unfortunate physique named Guillem wasn't always well accepted by his classmates or teachers due to certain peculiarities of his appearance and behavior. From our first encounters onward, he would explain to me by miming the ideas coming forward more so than by saying them, such as how he would like to be "a flying mutant" (who formed a resistance to save the planet from invasion from gaseous mutants), and upon seeing his mother at the end of the session, he would joyfully explain, "with the 'old man', I could talk about 'Mutant Buster'...". We were clearly dealing with identifications, which were just as present in his behavior as they were in his speech.  The child didn't call me the ‘old man’ afterwards, but by my name. It would be easy for him to say that he wanted to "escape into his dreams in order to think about other things", or to show me that he was interested in his own thought construction. His preoccupation with how he was perceived by others was also expressed from that point on.

Intention, anxiety, desire, depression, and conflict in the moment, and after the fact, intervene or mobilize somewhat rapidly for a child who is still organizing their identifications and infantile sexuality, even in the latent phase. A less lengthy amount of time is required for these elements to come forth. The question of interpretation arises more quickly than it does in an adult's therapy. The child will have beat us to it, but flooding the child with a surge of interpretations is not the point. In some situations, the analyst doesn't understand what has happened until after the work is done, but this matters little. The interpretative process undoubtedly took place, and the conditions in which it was established can sometimes suffice for analysis.

Some children ask the adults direct and precise questions, eventually metaphysical ones, which can be somewhat awkward so that the children become accustomed to not receiving a response, and they may even give up on asking other questions. We also are familiar with the litany of "whys" that some children use and abuse, sometimes systematically. The "why" isn't always an expression of curiosity. It can also be caused by anxiety or distress, or even because of their own psychic position of wanting to stay in contact with the person they are speaking to, to be heard, to eventually receive some response. Some children prove to be quite sensitive, and glad to simply be heard at last.

With the child, we can interpret the positions of the self (the imagination and personification of childlike thought invite this), but in terms of identification and not psychologizing. The self-subject is the question in this scenario, and its capacity of thought and reflection, not educating, teaching, or making it obedient.

Translation: Benjamin Muskal
 

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Dr med. Jean-Philippe Dubois
 


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