The idiot's dreams: rêverie in child psychotherapy

Am J Psychoanal. 2008 Mar;68(1):33-42. doi: 10.1057/palgrave.ajp.3350046.

Abstract

When exploring the frontier of the "border" cases, that is treating severely damaged patients, either by organic pathologies or by severe physical traumas or even by catastrophic emotional events, the classical technique is often forsaken to pioneer new trails, and we may utilize intersubjective actions. Some of these actions may occur very directly and suddenly, only later revealing their meaning in the après coup; others, on the contrary, may be the result of a not always easy or painless choice; in either case, these actions can have a great therapeutic meaning. I ventured to follow one such trail, together with the child I am going to speak of in this paper: the little "idiot" (as he used to name himself). He was suffering from an extremely severe phonologic disorder, which allowed him to utter only inarticulate noises; yet, a rich and deep internal world peeped out in the sessions, a world imprisoned but not completely annihilated by mutism. For many months, I have been trying to lend my voice to this world, by agreeing to narrate "my own" dreams within the play that was taking place in the sessions: in other words, I have tried to make use of my rêverie and capacity of identification in order to express the awful anxieties connected with the child's impossibility to communicate and to be understood: that is, with his huge loneliness. This work of "translation" did not take place with interpretation dresses, but as a repeated narration of dreams and nightmares, apparently mine yet, actually, deeply belonging to him. In this way a first step has been taken towards the raise of trust and hope of being understood, an indispensable requirement for him to finally get-after many years of work-to express himself and to make himself understood.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Communication
  • Countertransference
  • Dreams*
  • Fantasy*
  • Humans
  • Intellectual Disability / psychology*
  • Male
  • Mutism / psychology*
  • Mutism / therapy
  • Play Therapy / methods
  • Psychoanalytic Interpretation*
  • Psychoanalytic Theory*
  • Psychoanalytic Therapy / methods*
  • Self Concept