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Follow-up: Louise at six years old

My observations of Louise ceased at eighteen months because the family moved abroad. Mrs L maintained contact with cards and photos at Christmas time. I learned that Louise had gained a sister when she was rising three years old. It was not until the family came on a visit to London, when Louise was aged six that I was able to see them again. The visit was not the happy one I had anticipated. I scarcely saw the children, because Mrs L wanted to seize the opportunity to talk to me, as a child psychotherapist, about Louise's disturbance.

There had been no major difficulties until Louise's sister was born, when Louise amply confirmed Dunn's finding (1984, p. 143) that "in families with an intense relationship between mother and first-born daughter, the siblings are likely to be hostile". Soon after her sister's arrival she had become extremely oppositional and negativistic. She refused to accept affection from either parent and persistently wished her sister dead. She appeared to have no sense of concern for anyone who was ill or unhappy at home or at school, and she refused to say "please", "thank you", "sorry", "hello" and "goodbye". Worst of all, said Mrs L, she seemed convinced she was a bad person and was out to prove it. "How can she feel so bad when she was so much loved?" she asked.

Mrs L's account suggested that Louise had fulfilled Winnicott's prediction by rejecting her parents. She was the victim of extreme ambivalence. On the one hand, she refused to use words which tacitly acknowledged separateness, dependence, indebtedness, and concern. On the other hand, she insisted on defining a separate sense of self through opposition and hatred. Most seriously she had not apparently developed a sense of personal agency for love and concern, while her paranoid stance suggested a failure to differentiate a sense of agency with regard to hate.

Since this painful meeting with Mrs L, I have met with two other families in which an idyllic early relationship between mother and daughter had broken down into hatred and defiance. It was helpful to have learned how this could occur.

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