An object relations approach to therapeutic work with children in clinical settings

Master Thesis


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University of Cape Town

The aim of this paper is to elucidate an object relations approach to therapeutic work with children. The study is conducted by means of a critical theoretical evaluation of psychoanalytic and object relations conceptualisations of the nature of the primary biological mother-child relationship; an in depth theoretical exploration of the mother's involvement in and contribution to both optimal and pathological development in the child, and of her role in the child's treatment. The theoretical exposition is supplemented by the presentation and examination of clinical material derived from a child treatment case in clinical practice. Child treatment is located within an historical context; the role of parents in child treatment is addressed and divergencies in technical approaches to their inclusion in child treatment are reviewed. The nature of the primary biological mother-child relationship - its evolution, unconscious interrelational processes, optimal and pathological vicissitudes and its implications for child treatment - is explored. Simultaneous treatment of mother and child is offered for consideration, as an object relations approach which addresses the operation of both conscious and unconscious processes within the mother-child relationship, the vicissitudes of developmental disturbances and how these manifest in the therapeutic situation. The conclusion drawn is that an in-depth understanding of the primary relationship and its unconscious processes is of crucial importance in the assessment, diagnosis and treatment of children and that in many instances the mother needs to be directly involved in the treatment endeavour. It is further concluded that simultaneous treatment of mother and child is valuable in highlighting points of interaction between the disturbances of mother and child, and facilitates an understanding of the unconscious meanings and associations held by the mother in connection with her child, as well as the ways in which her unconscious expectations are fulfilled by the symptomatic child.

Bibliography: pages 106-121.