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Lucy at two years

Lucy is a two-year-old autistic child, born only eighteen months after her older sister, Cathy. At the beginning of this session Lucy's mother gives the therapist a cold reception, then asks her if she has children herself. In this, she is probably looking for some kind of support for her own role as a mother, as if the unconscious question were: "Can you understand my difficulties as a mother? Can you be supportive of my maternal functioning?" After this, mother becomes more confident and plays very happily with Lucy. By the end of the session, she is quite relaxed and friendly with the therapist.

During the subsequent seminar, while we were discussing why the mother's mood had changed so markedly, the therapist reminded us that in the previous session both children were present, Lucy and her older sister, Cathy. The mother had been monopolised by Cathy and had reacted angrily when the therapist pointed this out.

It would seem that in this earlier session mother had been trapped in projective identification with Cathy and had felt jealous of Lucy when the therapist began more particularly to observe her. In the present session, thanks to the supportive attitude of the therapist, mother managed to work through this feeling of jealousy and sort out the inter-generational confusion.

(iv) Providing a model for the observing function

As I have already pointed out, parents become increasingly interested in their infant's growing mental development as treatment continues. They tend to observe their child and note any progress he makes much more carefully than "ordinary" parents. To some extent we could say that they identify with the observing function of the therapist.

To my way of thinking, the therapist must avoid offering any other identificatory model— whenever, for example, a therapist is inclined to demonstrate how best to deal with the child in a given situation, this almost always denotes acting-out of some unbearable stress on the therapist's part. It is of course true that sometimes mothers do need concrete support, but in such a case home treatment of the kind I am describing is not a suitable technique.

 
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